North York Moors National Park Authority

Volunteer Service

Young Rangers Membership Form

Young Rangers details

First name: ____________________ Surname: ____________________ Gender: M/F

Address: _____________________________________________________________________________

Postcode: _____________________ Date of birth: ____/____/________

Contact number: _______________ Email address: ________________________________________

Emergency contact details

First name: ____________________ Surname: ____________________ Relationship: __________

Address: _____________________________________________________________________________

Postcode: _____________________

Contact number: _______________ Email address: ________________________________________

Young Rangers medical details

Does your son/daughter have any health problems, allergies, medical conditions or disabilities that may
affect their ability to participate in the Young Rangers Club? Yes/No

If yes, please give details:

Is your son/daughter taking any prescribed medication and will they need to take any medication during the
day? Yes/No

If yes, please give details:

Signature: ____________________ Date: ____/____/________

Name (block capitals): ____________________________________

Role / Job Title (please circle): Parent / teacher / other (please specify) ____________________________

North York Moors National Park Education Service

The Moors National Park Centre, Danby, Whitby YO21 2NB Tel: 01439 772700
E mail: education@northyorkmoors.org.uk www.northyorkmoors.org.uk
North York Moors National Park Authority
Volunteer Service

The National Park Authority is aware of the potential for images of children and young people to be
misused. The Authority takes health and safety matters seriously and will not share an image of your child
without prior consent. We comply with our Child Protection Policy and Data Protection Legislation.
Please tick
May we use your childs image in our publications, promotional material, website and social media?

Signature: ____________________ Date: ____/____/________

Name (block capitals): ____________________________________

Role / Job Title (please circle): Parent / teacher / other (please specify) ____________________________

Conditions of Use of Photographs / Images of Children and Young People

We will not include full names (unless we have a parents express permission in rare circumstances such as
a child winning a special award), postal or e-mail addresses with photos.

We will only use images of children or young people who are suitably dressed to reduce the risk of such
images being used inappropriately.

Images of children and details regarding consent will be stored securely and will not be shared with third
parties.

Useful information for the North York Moors National Park Authority

What would you like to gain from taking part in the North York Moors National Park Authoritys Young
Ranger Club?

How did you hear about the Young Ranger Club: (Please circle)

Facebook Twitter National Park website Word of mouth

Poster in Visitor Centre Other? (Please specify) _____________________________________________

Thank you

The North York Moors National Park Authority is registered under the Data Protection Act 1998. This
information will be treated as confidential and will only be used for the purposes of the North York Moors
National Park Authority.

Please return to Mary-Jane Alexander, Youth Engagement Officer, at m.alexander@northyorkmoors.org.uk

or the postal address below.

North York Moors National Park Education Service

The Moors National Park Centre, Danby, Whitby YO21 2NB Tel: 01439 772700
E mail: education@northyorkmoors.org.uk www.northyorkmoors.org.uk