Are you 18 years old or older?

Please state your date of birth

Email (if 17 and younger, this must belong to a parent / carer)

Contact number (if 17 and younger, this must belong to a parent / carer)

Do you (the participant) have any disabilities or learning difficulties?

If yes, please provide accurate information.

Please detail all information that BiG needs to be aware of to make your (the participant's) experience engaging in this programme the best it can be

Do you agree to complete all necessary monitoring forms so BiG can justify that all activities were delivered as promised?

All activities are funded by the National Lottery and BiG needs to prove that the funding was used to inspire and support young people as stated. We therefore cannot offer a place to those who are not willing to complete the monitoring form

Covid-19 related questions

Have you ever been tested positive for Coronavirus?

If so, please provide details / dates:

Do you agree to keep away from Dream BiG Wellbeing activities if you show any symptoms of coronavirus?

Additional information you would like to give

CONSENT

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