Registration Form

Personal Details = required

Full Name

Home Address

Home Phone

Work/Other Phone

Mobile Phone

Email Address

Alternate Email

Date of Birth

Gender

Male Female

Occupation

(Please indicate if you would be willing to help the youth project should it need your expertise.)

Membership Start

When would you like your membership to start?

As Soon As Possible Specific Date

Preferred Start Date
(if applicable)

Membership Category

Please select your preferred membership category

	Category	Cost
	Premium Time Out Youth Project add on. Time Out Youth Project add on. Support our Youth work in Sutton and get discounts! 10% discount on holiday camp. Discount on other paid events. Priority booking Only available to people up to the age of 18.	£15.00
	SM5 donation. Become an SM5 member and support our SM5 activities in Carshalton. SM5 provide free activities and support for the community with help from you. Lunches, stay and play, board games, take 5 and more. Only available to people aged 18 or over.	£10.00
	Premium Riverside Membership Become a Premium member of Riverside Centre 18+ Member benefits: (Renewal due every 12 months) - Discount on paid events. - Priority Booking. - Regular emails with information on our events. Only available to people aged 18 or over.	£12.00
	Premium Time Out Youth Project Membership Become a Premium member of Time Out Youth Project (For Children & Young People Aged Between 0-19, or up to 25 year for those with SEND) Member benefits: (Renewal due every 12 months) - Discount on paid events. - Priority Booking. - Regular emails with information on our events. Only available to people between the ages of 0 and 25 inclusive.	£15.00
	Basic Free registration. For all ages. - Allows access to book Riverside, Time Out Youth Project, SM5 events. - Regular emails with latest news and events. Add a Premium Membership for discounts on paid events, access to free events and more. Premium Membership is currently only £15 for 12 months. Only available to people aged 0 or over.	£0.00

Data Protection

I understand that any personal data I provide on this site will be processed in accordance with the Terms & Conditions and Privacy Policy. I have read and agree to the Terms & Conditions (https://toyp.myclubhouse.co.uk/Home/TermsAndConditions) and the Privacy Policy (https://toyp.myclubhouse.co.uk/PrivacyPolicy;).

Signature

Date

Please return completed forms to: Time Out Youth Project, Riverside Community Association Ltd, 113 Culver's Avenue, Carshalton, SM5 2FJ

Use this form to send an email to another member. You may only send to one member at a time. Your registered email address will be passed on to this member but you may also include alternative contact details.

Note: Emails sent via the website are not entirely private. A copy of every email is held on the database and this can be accessed by the youth project team members using the Sent Emails page.

From

Alternative contact email

Another email address which the recipient can use to contact you.

Alternative contact details

Other contact details which the recipient can use to contact you e.g. phone number.

Subject

Message

Copy this message to my email address

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