Te Pūtake

Thank you for your interest in our upcoming Te Pūtake Programme. Please register your details as required.

Te Pūtake

Designed to support young people aged 15-24 to develop both their personal and professional capabilities, preparing them for successful transitions into work, education, or community pathways. Free programme 3 x 5-week blocks

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Registration Details

Name of Person(First and Last Names)*

Date of Birth*

Contact Phone Number*

Contact Email*

I consent to engage with a Youth and Community team member from the Y Central South Island, and I understand that I can stop participating in this programme at any stage*

I understand

It is expressly understood and agreed that The Y Central South Island, shall not be responsible or legally liable for any loss of personal property or for any bodily injuries, or the results thereof, incurred and suffered by the applicant on any property of The Y Central South Island, or connection with any projects or activities, unless such loss or injury results directly from negligent or wilful act of an employee of the The Y Central South Island, acting within the scope of their employment.*

I understand

Consent to Release or Obtain Information – I give permission for The Y Central South Island to release or obtain information relating to myself from/to other organisations, agencies, etc. I understand that anything told to staff may not necessarily be kept confidential. If the information poses a danger to me or another person, or criminal activity is involved the matter will be discussed with others, The Y Central South Island staff or management. Agencies or services relating to the matter may be notified. Personal files are kept and stored on a secure client management system and may be viewed by me if requested. From time-to-time statistical data may need to be provided to, or sighted by our funders, referrers and by officials undertaking audits of our organisation. I agree to maintain the confidentiality of others in a group setting.*

I understand

I understand that If I am unhappy with the service I am receiving, I can make a complaint to the The Y Central South Island. I can make a complaint by talking to a staff member, sending the complaint in an email, or asking for the physical form.*

I understand

I give full permission for the the Y CSI staff and other qualified First Aiders, to administer First Aid in cases of emergency if required.*

I understand

I consent to participating in activities organised by the Y Central South Island. I understand the Y (CSI) will not be held responsible for any injuries or mishaps which occur, however, all necessary precautions and care to ensure everyone's safety will be taken.*

I understand

We give permission for photos or videos to be taken of me/us, which may be used for promotional purposes.*

Yes

Photos and videos maybe used in the Y Central South Island marketing collateral (EG: Social Media, flyers, adverts etc.)