Safeguarding Day Booking Form

Please complete a separate form for each attendee.

My name is (please give forename and surname):  *

My email address is:  *

My mobile number is (only for any last minute changes we need to tell you about, we don't retain this after the day): 

How would you rate your current level of safeguarding knowledge?:  1 - Low
2
3 - Average
4
5 - Good *

What describes your interest to attend?:  I'm a DSL for an ecclesia/organisation/camp etc
I have a different safeguarding role
For general interest/development *

Does your ecclesia/organisation/camp have a safeguarding policy?:  --- SELECT ONE --- Yes, we used the CSN template Yes, we based it on another template No, but we're working on it No *

Which ecclesia/organisation/camp is this?: 

Is there is anything you would like to ask or share confidentially with the day’s organiser?: 

If you have dietary requirements or mobility needs, please tell us here: 

I consent to CSN holding my personal data and contacting me with news and invitation mailings:  Yes
No *

You can read our data privacy policy at: https://www.chsn.org.uk/privacy