Testing Youth Group Registration Form

    Which youth group would your child like to attend?

    Has your child ever attended an Autism Berkshire youth group before?

    If my child is offered a place, I agree that they will attend all sessions, and that if my child does not attend regularly, their place may be given to another child on the waiting list. Each case will be considered on an individual basis if, for example, your child is ill.

    Have you/do you access any other activities that Autism Berkshire offers?

    Tick the box that best describes you

    What is your child's gender?

    Can your child manage well in a 1:4, staff:child situation?

    Does your child have an Autism diagnosis?

    I am happy for my child to receive first aid or emergency medical treatment by trained Autism Berkshire staff or medical authorities.

    Does your child often become physically or verbally aggressive?

    Does your child abscond from settings or people (e.g. school, home or groups)?

    How did you hear about Autism Berkshire?

    [select* hear_about include_blank "Autism Berkshire Website" "CAMHS" "Local Offer" "Word of mouth" "Through one of our other services" "At a local event, e.g. fundraiser, fete]

    Data Protection

    I consent to my child having photographs/videos taken for use in publicity for Autism Berkshire and the NHS.

    Data Protection (please tick all that apply):

    I am happy to be contacted by (please tick all that apply):

    Your confirmation:

    Privacy Notice

    We will always store you personal data securely. We will use them to communicate with you and to provide any service that you have requested. Your data may also be used for analysis purposes to help us provide the best possible service and for monitoring purposes by our funders. We will only share it if it is required to do so by law.

    For details of our Data Protections Policy, please see our website at

    A copy of your responses will be emailed to the address that you provided.




    Testing for the Trampolining Waiting List

      Parent/Carer first name:

      Parent/Carer last name:

      Email address

      Telephone number

      Child first name:

      Child last name:

      Child's age:




      We run 3 trampolining sessions at Meadway Sports Centre, Crosfields School and Bracknell Trampoline Centre. Which of these sessions would you like to go on the waiting list for? (Check all that apply) *


      Which venue would you prefer when a space becomes available?


      My child... *


      Does your child have any additional needs we need to be aware of? E.g. are they non-verbal? do they tend to abscond? do they need visual cues to communicate?


      All details will be treated as confidential and will not be shared or passed on to other parties without your knowledge and consent