Building Stories Membership Form

This form is for young people who are interested in joining our free Building Stories sessions:

Comics Club: 8-13s, Saturdays 10-11.30am

Comics Corner: 14-17s, Wednesdays 4-5.30pm

Comics Encounters: 18-25s, Tuesdays 6-7.30pm

Please note: If you’re under 16 a parent or guardian will need to fill this in for you.

Choose a Session

Referred by

Name

First Name

Last Name

Preferred Name

First Name

Last Name

Gender

(Male, Female, Non-Binary, etc.)

Date of Birth

YYYY

Address

Contact Number

How would you like us to contact you?

Phone, text, email, WhatsApp

School/College

Ethnicity

Medical Conditions

Disability

Additional Needs

If "Yes" to the above, please provide details.

Parent/Guardian/Emergency Contact

If you are under 16, a parent or guardian must fill out the information below.

Name

First Name

Last Name

Relationship to Young Person

Address

Phone Number

Additional Emergency Contact

If we are unable to reach your parent/guardian in an emergency, we will try to contact this person instead.

Name

First Name

Last Name

Relationship to Young Person

Address

Phone Number

Your Personal Data

By signing up for the Building Stories Project you agree to provide Comics Youth SCIO with certain personal information, which we will process in accordance with all applicable data protection laws to: Provide you with services and carry out administration in relation to your membership; Communicate with you and your parent / guardian about your membership; Provide information about your membership to suppliers, funders and/or sponsors as required for the purposes of the development, coordination and support of Comics Youth SCIO.

Your Sensitive Personal Data

We may collect sensitive personal information for example, information relating to your health, disability and/or ethnic background.

I agree that my sensitive personal information can be processed to provide me with services and carry out administration in relation to my membership.

I agree that my sensitive personal information may be shared with suppliers, funders and/or sponsors (as required for the purposes of the development, coordination and support of the Comics Youth SCIO). Comics Youth SCIO will ensure that third parties agree to keep this information confidential.

Your Image

I agree that my image (in photos or videos) may be used for marketing and publicity purposes in printed publications, on social media, on the Comics Youth CIC website or elsewhere.

Yes

Your Artwork

I agree that my artwork (in photos or videos) may be used for marketing and publicity purposes in printed publications, on social media, on the Comics Youth CIC website or elsewhere.

Yes