General wellbeing programme Booking form

GENERAL YOUNG PEOPLE WELLBEING PROGRAMME - BOOKING FORM

    Please complete the below booking form if you would like to join one of our general wellbeing programmes for young people. If you are under 16, your parent or guardian will need to complete the form on your behalf. Fields with * must be completed please.

    (please enter an email that will be checked regularly for updates)

    (if under 16)

    MEDICAL DETAILS

    Please note that staff only have basic first aid training, so it is the responsibility of the participant/parent/guardian to arrange any medical safeguarding measures required. Regrettably, the venue is not suitable for wheelchair users.

    PROGRAMME - Please check which programmes are available on our website before completing this form, checking the date and time of the programme you wish to book, as we often have more than one programme running a day.


    PHOTOGRAPHY OR FILMING

    During some activities, staff, authorised volunteers or partner organisations will take photographs and/or film parts of the session. Please indicate below if you consent to The Wild Mind Project taking photographs or films of participants and/or participant's project/artwork, and authorise us to use, reuse, copy, publish, display, exhibit, reproduce and distribute the materials in any educational or promotional materials or other forms of media without notifying you. Participants will not receive any payment from The Wild Mind Project for giving consent or as a result of any publication of the materials.

    I give permission for myself/my child's project/artwork to be photographed/filmed as per above YesNo

    I give permission for myself/my child to be photographed/filmed

    LIABILITY WAIVER

    This waiver of liability includes any risk of attending The Wild Mind Project programmes, events, workshops or other services provided by The Wild Mind Project. Please see the detail below:

    • Participants using The Wild Mind Project’s services understand that these services are not offered as a substitute for clinical mental health care or medical care, and are not intended to diagnose, treat or cure any mental health or medical conditions. You also understand that The Wild Mind Project leaders are not acting as medical professionals.
    • You understand and agree that you are fully responsible for your own/your child’s (if the participant is under 16 years of age) wellbeing during your sessions, and subsequently, your choices and decisions.
    • You also understand that all comments and ideas offered by a leader, are solely for the purpose of aiding you in improving or enhancing your mental wellbeing. You hereby give such consent to your leader to assist you in achieving such aims. Where we think it is in the interest of your wellbeing, we may contact your GP or authorised safeguarding body to share relevant information.
    • You have read and understood the Privacy Policy and other documentation relating to confidentiality, adult safeguarding or child safeguarding.
    • You hereby release, waive, acquit and forever discharge The Wild Mind Project CIC directors, staff, volunteers, consultants and partners from every claim, suit action, demand or right to compensation for damages claimed or that you may have arising out of your own acts or omissions or acts and omissions of your leader as a result of any advice given otherwise resulting from the leader’s relationship contemplated by this agreement. You further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made.

    COVID-19

    If have Covid-19 symptoms (high temperature, a new continuous cough, or loss or change to your sense of smell or taste), please DO NOT ATTEND THE SESSION.

    SIGNING AND CONSENT

    By entering my name below, I hereby confirm that I have read, understood and agree to the contents of this form and The Wild Mind Project's safeguarding policy, privacy policy and our terms & conditions. I understand and agree that no oral or written representations can or will alter the contents of this document.

    Safeguarding

    The  Wild Mind Project (TWMP) works with vulnerable adults and young people and is committed to ensuring that those who participate in TWMP’s activities do so in a safe, confidential and enjoyable environment. Please refer to TWMP website for our Safeguarding Policies.

    Privacy

    TWMP use information held about participants in the following ways:

    • To provide participants with the services requested from us.
    • To notify you about changes to programmes/events and other changes to our services.
    • To administer our service, including the handling of donations, and for financial control, data analysis, research, statistical and survey purposes.
    • To ask for feedback three months after attending programme to provide analysis for future funding/programmes.
    • To keep in touch with those who consent to this.

    TWMP will not share any information about participants with other organisations or people, except in the following situations:

    • Consent – TWMP may share your information with professional carers or others whom you have requested or agreed we should contact.
    • Serious harm – TWMP may share your information with the relevant authorities if we have reason to believe that this may prevent serious harm being caused to you or another person.
    • Compliance with law – TWMP may share your information where we are required to by law or by the regulations and other rules to which we are subject.

    Please refer to TWMP website for our full Privacy Policy 

    We are glad that we are able to secure funding to enable the programmes to be free of charge. However, there is a lot of demand for young people’s emotional and mental health support, so we ask that you please commit to ALL the dates in the programme you are booking. This also greatly benefits the other members of the group. Thank you.

    “This feeling will pass. The  fear is real but the danger is not”. Cammie McGovern.