Ballyholme CSSM Registration Form

  • Ballyholme CSSM Family Registration Form

    To be completed by the child's parent/guardian.

  • Ballyholme CSSM 2026

    Week A: 6 - 10th July

    Week B: 13 - 17th July

     
     

    How Registration Will Work

     

    STEP 1 - Register Interest

    This year, we invite you to register all children/young people in your family wishing to attend CSSM via this form. You will fill in a consent form, detailing the necessary information of your child or young person and must fill in one form per child i.e. Three children = Three forms.

    You will be prompted to create and submit a unique code to identify your family. You must add the same unique code to each of your families consent forms in order for the Ballyholme CSSM team to identify family members of the same family. This will dramtically reduce the adminstrative workload for our volunteer leaders.

     

    STEP 2 - Await Confirmation

    Our voluntary team leaders (Kurtis and Bethany) will contact you, via email, within 2 weeks to confirm your child's place. Please check your junk/spam folder for this correspondence. Ballyholme CSSM will also operate a wait list and the team leaders will contact you, should a space become available. 

  • Important Information

    Please Note This Information Before You Begin

  • Sections

     

    At Ballyholme CSSM there are 6 Sections (or age groups).  Please use this form to identify which Section your child will be in.

     

    School years as of September 2026

      Minis P1 - P2
      Micros P3 - P4
      Minors P5 - P6
      Majors P7 - Y8
      Midis Y9 - Y10
      Maxis Y11 -Y13


      

    Week A and Week B

     

    To accommodate as many children and young people as possible, Ballyholme CSSM runs the same programme twice.

     

    Once in "Week A" and again in "Week B".

     

    Please use this form to indicate which (if any) week you prefer.

      Week A 6 - 10 July
      Week B 13 - 17 July

     

     

    Note for Maxis Y11 - Y13

    Maxis may attend both Week A and B, unlike other sections.


    If they would like to attend both weeks, please select 'both' from the drop down.  

    If they would like to attend one week, please select either Week A or Week B from the drop down.

  • Family Registration

  • To create your unique family code please add your house number, surname (without special characters) and the last two digits of your phone number. This must be referenced in each of your childrens consent forms.

     

    For example,

    301 Hawthorne Drive

    John Smith

    +447487510240

    Unique family code: 301smith40

     

  • Child's Information

  • Medical Information

    The information you provide will be used to help keep your child safe and well during this SU Mission.  Those in leadership of the mission and each section will hold this information and, if necessary, it may be shared with other leaders e.g the first aider. In an emergency it will be shared with medical staff.
  • Medical Conditions*
  • Does your child carry an Epi Pen?*
  • Do you give permission for a trained first aider to administer your child's Epipen?*

  • Thank you for your response. The Team Leaders will be in touch to discuss the options for your child's involvement at this SUNI Mission.

  • Additional Needs and Support

    This information will be seen by the Team Leader(s) and Section Leader(s) and used to plan for all activities. It will only be shared, as necessary, with your child's Small Group Leader. In the case of an injury or emergency, medical staff will also be told this information. In the case where your child has additional needs we will make every effort to welcome them to our programmes however this may not always be possible due to volunteer availability and limited resources. NB - This may be a formal diagnosis or ongoing assessments.
  • Should we be aware of any additional needs for your child?*

  • Learning Needs and Support

  • Does your child receive any support for additional needs at school?*

  • Physical Needs

  • Does your child have any physical disabilities?*

  • Speech and Behavioural Needs

  • Does your child communicate through speech?*
  • Does your child understand and respond to spoken word?*
  • Does your child have any problems with new situations?*
  • Does your child have any problems coping with new people?*
  • Which does your child prefer?*
  • Does your child have any specific behaviour issues? (For example, coping with correction, complying with instructions)*

  • Intimate Care Requirements

  • Is your child independent with toileting requirements?
  • Does your child require help with toileting?

  • By selecting 'Yes', you are giving permission for a team member to help your child with toileting and their personal care.

  • Getting to Know You!

    In order to help us ensure that your child's experience at this SU programme is the best it could be, we would love to know a little bit more about them! We would really appreciate information on the following areas where relevant.

  • Friends and Family

  • School

  • Likes and Dislikes

  • If you are filling out this form in advance of the mission, a member of the volunteer team will endeavour to be in contact before it starts, however, this may not always be possible.

  • Emergency Contact 1

  • Emergency Contact 2

    If we cannot contact the individual listed as Emergency Contact 1, we will contact Emergency Contact 2

  • Permissions

    I (having parental responsibility for the above named person) give consent and permission to the following:
  • Any emergency medical treatment that may be necessary during the duration of the SUNI activity.*
  • MAJORS, MIDIS & MAXIS SECTIONS: I give permission for my child to walk home alone.*

  • Thank you for your response. The Mission Leader will be in touch with you to discuss the options for your child's involvement at this SUNI activity.

  • I give permissions for photographs and video footage of my child/young person to be used on printed materials, on the SUNI website and/or on SUNI's social media accounts*

  • Data Protection

    The information you have given us in this form is held and used throughout the time of the activity. We do not share information with any other organisations unless there is a Safeguarding concern. For insurance reasons this information will then be securely archived. To find out more about how we use your information please visit our Privacy Policy - www.suni.co.uk

  • Authorisation

  • Date*
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