Become A Member

Name

Date of Birth

Address (including postcode)

Mobile Number

Parent/Guardian Name

Parent/Guardian Mobile Number

Parent/Guardian Email Address

Your Interests (list at least five interests & hobbies)

Any medical conditions or allergies that youth-shine should be aware of.

Which type of activities do you think youth-SHINE can provide that would interest you?

How would you like us to keep in touch with you? How would you like us to keep in touch with you? Mobile Email

Agreement Agreement By becoming a member of Youth-SHINE you agree to provide us with certain personal information, which will be processed in accordance to the data protection laws. It will allow us: To carry out administrative duties in relation to your membership. To provide you appropriate member services To communicate with you (and your parent / guardian) about services and your membership. You can opt out of this agreement at any time by emailing us at admin@youth-shine.org.uk