Y Whānau

Y Whānau Registration Form

Equip yourself with practical tools to confidently navigate the adolescent years. Over six once a week sessions you’ll gain insight into: ✅ Adolescent brain development ✅ Parental styles, support systems, boundaries and self care ✅Effective communications tools ✅ Navigating the social scene and digital landscape ✅Plus tips for the teenage years and so much moreThese sessions run every Thursday from September 3rd to October 8th, 6pm – 8pm at the Y Youth and Community, 7-9 Sophia Street.

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Your Details

Ethnicity*
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 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.*
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 that participating in the use of any equipment provided by the Y or associated organisations has risks. I voluntarily choose to participate and accept responsibility for the risks associated with the activity and equipment. I confirm that I am physically able to take part and will participate with knowledge of the above-mentioned risk*
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 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 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 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.*
We give permission for photos or videos to be taken of me/us, which may be used for promotional purposes.*
Photos and videos maybe used in the Y Central South Island marketing collateral (EG: Social Media, flyers, adverts etc.)