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3rd Gidea Park (St. Michaels) Scout Group - Registered Charity Number 267354

Section Beavers (Penguins): Beavers (Polar Bears): Cubs (Tigers): Cubs (Leopards): Scouts: Age Range 6-8 6-8 8 ­ 10 ½ 8 ­ 10 ½ 10 ½ - 14 Regular Weekly Meetings Thursdays Fridays Tuesdays Fridays Thursdays 5:15pm ­ 6:30 5:15pm ­ 6:30 6:30pm ­ 8:00 6:45pm ­ 8:15 7:30pm ­ 9:15 Meeting Place Rowswell Hall St Michael's Church Main Road Gidea Park (Not a postal address)

APPLICATION FOR MEMBERSHIP

For Admission into Beavers (Aged 6-8)/ Cubs (Aged 8-10½ ) / Scouts (Aged 10-14) (Please specify) Child's Full Name ................................................................................................................................................ Date of Birth ............................ Home Tel No. ................................................................................................... Address: ............................................................................................................................................................ ............................................................................................................................................................ ............................................................................................................................................................ ............................................................................................................................................................ Parent's/Guardian's Names and mobile telephone numbers Parent/Guardian 1 ............................................................................................ ............................................................................................ ............................................................................................ Mobile: Email: Parent/Guardian 2 ............................................................................................ ............................................................................................ ............................................................................................ ............................................................................................ ............................................................................................ Mobile: Email: ............................................................................................ ............................................................................................

Child's School: .................................................................................................................................................... Religion/Religious Preference: ......................................................................................................................... Please be advised that we are a church affiliated group. All members are encouraged to attend Church Parade on the second Sunday of each month. Family members are welcome to attend the parade and to join us for refreshments afterwards. This is the ideal opportunity to speak to the leaders and view the photo displays in the hall. Does your child have a disability? YES / NO (This will not affect your child's place in the group, it just helps us complete our annual census and ensure we can support your child's needs) (If the answer is YES, please specify by ticking below) Dyslexia Personal Care Support Autistic spectrum Mental health difficulties Blind/partially sighted Multiple disabilities Deaf/Hard of hearing Unseen disability e.g. diabetes, epilepsy, etc Wheelchair user/mobility difficulties A disability not covered above (please state) ....................................................................................................... Does your child have any other support need or condition that is would be advantageous for us to be aware of? i.e. allergies, asthma, behavioural issues. (Please specify) ........................................................................... ..............................................................................................................................................................................

Group Scout Leader: Angela Hutton Address: 71 Hamilton Drive, Romford, Essex, RM3 0UX W:www.3gp.org.uk Registered Charity No: 267354 (England & Wales)

How would you describe your child's ethnic origin? (Please tick) White English/Welsh/Scottinsh/Norther Irish/British Irish Gypsy or Irish Traveller Mixed/Multiple Ethinc Groups White and Black Caribbean White and Black African White and Asian Asian/Asian British Indian Pakistani Bangladeshi Chinese Any other White background (please specify) Any other mixed/multiple ethinic background (please specify) Any other Asian background (please specify)

Black/African/Caribbean/Black British African Caribbean

Other ethnic group Arab Other (please specify)

Any other Black/African/Caribbean background (please specify below)

Does your family have links with this Scout Group or with St Michaels Church? If Yes, please explain............................................................................................................................................ Gift Aid Declaration: The 3 Gidea Park Scout Groop is a not for profit charity run entirely by volunteers. If you pay income tax or capital gains tax, then you can gift aid any membership subscriptions you make to the group. (For every £1 subs you give, we can claim back 28p from the tax man) If you are happy for us to claim gift aid in this way, please sign below. I want the Scout Association to treat all eligible donations and member subscription payments I make on or after the 6th April 2000 as Gift Aid Donations for the Association. PRINT NAME .. . Signed . Date

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Photographs - From time to time, we take photographs of our members, mostly for our own displays and website, but occasionally for wider use in scouting publications. No child is identified by name from these pictures and all use complies with the Scout Association's Child Protection Policy. Please indicate whether you give permission for photographs to be taken of your child YES I give permission to photograph my child on scout events / NO I do not give permission Signed (Parent/Guardian) ....................................................................... Date ................................................ Copies of any photos taken are usually available on request. Occasionally after camp DVDs of photos are sold to members to help raise money for group funds. Completed Forms Please return a copy of this form, completed to the Group Scout Leader (GSL) Angela Hutton (GSL) 71 Hamilton Drive, Romford, Essex RM3 0UX Every effort will be made to contact you before your child reaches the entry age for your chosen section. Joining Fee When your child actually starts attending meetings a joining fee of £30 must be paid. Cheques should be made payable to 3 Gidea Park Scout Group.

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Group Scout Leader: Angela Hutton Address: 71 Hamilton Drive, Romford, Essex, RM3 0UX W:www.3gp.org.uk Registered Charity No: 267354 (England & Wales)

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