Westfield Health British Transplant Games
Northern Ireland
04 - 07 August 2011
Volunteer Application and Consent Form
These details will be used by Volunteer Now during the British Transplant Games and relevant training
sessions. If any details change after you have completed this form please let us know as soon as possible.
Please complete this form clearly and in BLACK INK or TYPE
PERSONAL DETAILS
Surname:
Title:
Forename(s):
Date of birth:
Age:
(Please note you must be 16 by
Address:
01 June 2011)
Post code
E-mail Address:
Home telephone number:
Mobile telephone number:
School, College or University you are studying at:
For Under 18s we require Parent / Guardian contact details which will be used for all
communications:
Parent name:
Home and Mobile Telephone Number:
Email Address:
Please tell us why you would like to volunteer for the British Transplant Games?
Please detail any qualifications (e.g. Child Protection, First Aid, Event Management for Volunteers)
including membership of professional associations or any other relevant training that maybe applicable for
this role.
Please outline any events, sports or activities you are currently involved in and in what capacity i.e.
participant, coach, official etc.
Please give details of any additional information in support of your application to be a volunteer at the
British Transplant Games
Please state your availability below (tick if available / leave blank if unavailable)
Training (at Reception Room, Belfast City Hall)
Please note you only need to attend one training session
Thursday 21 July, 6.30-8.30pm
Wednesday 27 July, 6.30-8.30pm
Games
Wednesday 03 August (set up) - Hours available _____________________________
Thursday 04 August - Hours available _____________________________
Friday 05 August - Hours available _____________________________
Saturday 06 August - Hours available _____________________________
Sunday 07 August - Hours available _____________________________
Monday 08 August (set down) - Hours available _____________________________
Would you be interested in volunteering with any launch events prior to the Games?
Yes
No
Please tick which role(s) you would prefer to volunteer for?
(Full Roles Descriptions attached and please note there is no guarantee you will be matched to this role).
Sport Specific Volunteer
Open Ceremony Stewarding
Venue Branding
Games Information Desk
Registration
General Event Volunteer
Airport Welcome Desk
Please inform us below of any medical information or food allergies we may need to know about during the
Games and training sessions. Please be aware it is your responsibility to look after and take such
medication as appropriate.
In case of an emergency, during the Games or Training, please include two contact names and details
Contact 1
Contact 2
Name
Name
Relationship to volunteer
Relationship to volunteer
Address (if different to above)
Address (if different to above)
Telephone
Telephone
Mobile
Mobile
Email
Email
Please include below information for References
Reference 1
Reference 2
Name
Name
Relationship to volunteer
Relationship to volunteer
Address
Address
Telephone
Telephone
Mobile
Mobile
Email
Email
How do you know this person?
How do you know this person?
Please tick / fill in as appropriate:
Please send me details about entering the Donor Run
Please send me details about signing onto the NHS Organ Donor Register
I am happy to be contacted for PR ahead of the Games
Please list (in the box) your T shirt size (XS, S, M, L, XL, XXL)
I confirm that I / my child is in good health and I consider myself / them capable of taking part in the British
Transplant Games in a volunteering capacity.
I am aware that photographs and video footage will be taken during the events and relevant training
sessions for promotional and broadcasting purposes, and I give consent for me / my child to feature in such
photos and footage (if you do not give consent please contact us directly, otherwise we will assume you are
happy for this to happen).
I confirm that all information given in this application is correct to the best of my knowledge, that all the
questions related to me / my child have been accurately and fully answered and that I am in possession of
the qualifications I claim to hold. I give my consent to Volunteer Now to record, process and validate my
personal information and sensitive personal data in line with Data Protection and all other legislative
provisions.
For those under 18 we require a counter signature of a Parent / Guardian. This form also confirms you give
permission for your child to volunteer at the British Transplant Games and attend any relevant training.
Name of Volunteer (in print):
Signature of Volunteer:
Date:
Name of Parent / Guardian (in print):
(This must be a person with legal parental responsibility)
Signature of Parent / Guardian:
Date:
The information that you provide on this form and that obtained from other relevant sources will be used
to process your application. The personal information that you give us will also be used in a confidential
manner to help us monitor our recruitment process. If you succeed in your application and take up the
voluntary opportunity with us, the information will be used in the administration of your role with us. We
may check the information collected, with third parties or with other information held by us. We may also
use or pass on to certain third parties information as permitted by law.
These details will be held securely within Volunteer Now for the purposes of the British Transplant
Games. By completing this form you are consenting for Volunteer Now to hold and use this information
for the purpose of the project. Relevant details maybe disclosed to partners connected with this event, as
appropriate.
Please note not all applicants may be successful
Please return this form to the contact below by Wednesday 01 June 2011
Lyne Greenwood
2012 Project Manager
Volunteer Now
34 Shaftesbury Square
Belfast
BT2 7DB
E: [email protected]
OFFICE USE ONLY
Date Received
Date Acknowledged
Application Number