Membership Form
Membership will entitle you to receive all our regular newsletters as well as having access to our great value trips & activities. Please include all those living in your immediate household when completing this form. Existing members will be invited to renew each April. Annual Family Membership Fee is £31.00. If you join Escape in …… Membership will be – April/May/June £31.00 July/August/September £23.25 October/November/December £15.50 January/February/March £7.75
Parent(s)/carer(s) First Name(s)
Last Name
Email
Phone Number
Address
Date
Would you like to receive newsletters/Info via email (pleases select)?
Select an option
Yes
No
Do you give your consent for photos to be taken and displayed (website, social media, marketing materials, etc.)?
Select an option
Yes
No
Child's name
Date of birth
Disability/additional needs
School attended
Childs's name
Date of birth
Disability/additional needs
School attended
Child's name
Date of birth
Disability/ additional needs
School attended
Child's name
Date of birth
Disability/additional needs
School attended
Do you have any additional family members that might wish to join in with our activities? Please include anyone this applies to i.e. grandparents, siblings, additional carers,etc.
Do you have your own transport?
Select an option
Yes
No
When using transport that is provided for our trips, do you have any special transport needs? For example Wheelchair users, 3 point seat belts
Any other information you feel we should know including health issues or medication required, etc?
How did you hear of ESCAPE Support Group?
Gift Aid
For every £1 you give to us we get an extra 25p from the Inland Revenue. To qualify for Gift Aid you must be a UK taxpayer and pay an amount of income tax or capital gains tax at least equal to that which we reclaim on your donations in the tax year. By ticking the Gift Aid box you agree that your donation will be subject to Gift Aid and that you are a UK taxpayer and understand that if you pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all your donations it is your responsibility to pay any difference. By selecting 'Yes' I Confirm I am a UK taxpayer intending tax to be claimed on all future donations made under the gift Aid Scheme
GIFT AID IT - Can you help us make your money go further ?
Select an option
Yes
No
Please read through these guidelines and notes and click below to acknowledge your acceptance. A copy of this will be provided in your New Member Handbook. If there is anything that you are not agreeable with please notify us in writing to The Chair of ESCAPE, ESCAPE SUPPORT GROUP, Unit H, Creech Business Park, Creech St Michael, Taunton, TA3 5PX Whilst ESCAPE does everything within its power to research all aspects of its activities and outings including all Health and Safety issues, the following should be carefully noted. In order to ensure that ESCAPE continues to be welcomed everywhere, each individual Parent/Carer must be ultimately responsible for the care and behaviour of all persons within your family group (children or otherwise) whilst attending any activity or event, organised by ESCAPE. ESCAPE is unable to offer a child care facility during activities or outings therefore each and every child must be supervised at all times by the accompanying Parent/Carer. To date we maintain a high reputation for being a courteous and polite group and it is most important that we continue to uphold this tradition. It is your responsibility to always leave a tidy site. Please ensure you leave all modes of transport used and every place visited as you found it. ESCAPE cannot be held responsible for damage done to property or items belonging to the various Services upon whom we depend. Should any individual be in the unfortunate position to have accidentally damaged anything the onus is on that individual to declare that damage and to the best of their ability “put it right”. Whilst extended family members are of course always welcome by ESCAPE on activities and outings, we request that you limit this to two subsidised extra people. If you require more than two places, within reason, these can be obtained at the full price of the activity. If in any doubt consult either of the Charity Co-ordinators who will be happy to advise. Any medical requirements that a family member requires, and any first aid that may need to be administered is the responsibility of the accompanying Parent/Carer. ESCAPE often needs photographs, video footage, comments and quotes of and by its members. These help us to secure funding and to help promote a positive image of ESCAPE in the media. We would like to make it clear that we fully accept all individuals’ rights to privacy and therefore should you wish us not to use photos/quotes etc please delete as necessary above. Due to circumstances beyond our control there may be occasions when our activities and outings may have number restrictions, be altered or withdrawn without prior notification.
I consent to Escape Support Group holding my information in line with GDPR
I have read & agree to Escape Support Group Terms & Conditions
I have read and agree to the Safeguarding Policy
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