Holiday Application

Holiday Dates

Please note - Youth Cancer Trust holidays take place from Mondays to Fridays (not weekends), all year round.

Companion

Will you be bringing a companion?NoYes

Your Parent / Guardian / Next of Kin details in case of an emergency

Full name of Parent / Guardian / Next of Kin:

Parent / Guardian / Next of Kin Phone Number:

Emergency Medical Treatment Consent

In the event of a need for emergency medical treatment and parents/guardians/next of kin cannot be contacted. I (parent/guardian/next of kin) give permission to the staff of Youth Cancer Trust Holidays to give consent for such treatment for the applicant on my behalf:

Please provide E-Signature of Parent / Guardian / Next of Kin named above:

The applicant's GP has agreed that the applicant is fit to come on a Youth Cancer Trust holiday. A parent / guardian / next of kin E-Signature is required if the applicant is under 18.

Applicant's E-Signature if over 18.

Youth Cancer Trust Holiday Activities

Activities are optional and if the applicant does not feel well enough to take part, they can either accompany the group or stay at the house. Activities can include horse riding, go karting, water sports, sailing amongst others

Are any activities to be avoided?

Transport Planning

Please read and complete the following carefully: Please book your travel tickets at least 14 days in advance to obtain preferential rates and then confirm all of your travel arrangements with the office (01202 763591 or admin@yct.org.uk or via our Facebook page). If you need help with your travel arrangements, please let us know as soon as possible at the time of booking your holiday. YCT holiday guests and companions are asked to arrive after 2pm on the Monday and to leave Tracy Ann House by 11am on the Friday if possible. We understand if train times do not permit this.

How will the applicant get to and from Tracy Ann House in Bournemouth?The applicant will be driving to and from YCT in their own carThe applicant will be given a lift to & from YCT by a parent / guardianThe applicant will be travelling by trainThe applicant will be travelling by planeNot sure of travel arrangements yet

Parent / Guardian Consent - If Applicant Is Under 18

If applicant is under 18. “To the best of my knowledge, at this time, this is a true and accurate description of my child’s needs”

Parent / Guardian E-Signature (if applicant is under 18):

Agreement

We understand that sometimes holidays have to be cancelled at short notice due to ill health. However, if you have to cancel due to work or other activities, please do give us as much notice as possible. These holidays cost the charity substantial amounts of money so please allow us plenty of time to offer your place to someone else.

Person completing form

Agreement signed:

Publicity

To encourage funding and support of the Youth Cancer Trust we sometimes use photos of the groups during their holidays and make reference to the applicant's stay at Youth Cancer Trust for press releases and other promotional / publicity materials. We may include their first name (not surname), age and the area they live (not address) E.g. Vicky, aged 16 from Dorset.

Please indicate if you (the applicant) are happy to be part of any publicity material for Youth Cancer Trust?NoYes

Sometimes a photograph will be used more than once in marketing materials. Please indicate if you are happy for this to happen?NoYes

Has the applicant any criminal convictions (apart from road traffic offences)?NoYes

Online Support Application

Youth Cancer Trust run a secure Facebook group for our guests. If you would like to be added to the Facebook group, please add your Facebook profile or Facebook email address below

Facebook Contact

If you are under 18, please ask your parent / guardian to sign to give their permission for you to access our Facebook group.

Activities and Support

What activities and support are you interested in?

We are open to your ideas and suggestions and will try our best to make them happen where possible. Please use the box below to tell us any ideas for activities/ support you would like to see included.

Terms and Conditions

Unless specifically stated, the online activity and support programme, and secure Facebook group is for Youth Cancer Trust guests only.

The term 'guest' refers to anyone meeting our criteria:

'young people aged 14 to 30 living with cancer or any malignant disease from anywhere in the UK and Irish Republic or who are patients of any UK hospital. You can also join our program if you have been in remission for up to 5 years, or are living with the late effects of having had cancer as a teenager.'

At our discretion, we are also currently accepting applicants meeting the above criteria who are over 30 years of age.

All guests participating in our online programme agree to at all times treat peers and staff respectfully and courteously, or may be asked to leave the programme.

All content in the secure group including guest’s comments, photos, zoom recordings and zoom links are strictly to remain within the group only and not to be shared publicly, unless permission has been granted from the individual or group moderators.

Youth Cancer Trust will not tolerate any bullying or intimidating behaviour and reserve the right to remove and block anyone from accessing the secure group and activities if they do not adhere to the above conditions.

Should guests experience any bullying from peers or they have any concerns / grievances please report to one of the group moderators immediately.

Guests participating in physical activities hosted by Youth Cancer Trust must seek advice / permission from their GP first if they are not currently physically active.

Agreement

I agree to adhere to the above terms and conditions at all times. I understand that failing to do so may result in me being removed from the group.

Other

How did you hear about us?

Thank you for taking the time to complete this form

The completion of this form is a legal requirement for Youth Cancer Trust. Please Note Youth Cancer Trust does not disclose personal data to third parties. Personal data is kept confidential and only used for the purposes of arranging your holiday and keeping in touch with you. If you have any questions relating to this form or Youth Cancer Trust holidays please telephone 01202 763591 and we will be happy to help.

By submitting this form, you are adhering to our terms and conditions and if you are under 18 you are confirming that you have permission from a parent or guardian that you are allowed to join the online community. Your details will be kept safe in line with our strict data protection policy.

If you have anything you would like to add, please do so here. PLEASE REMEMBER TO CLICK 'SUBMIT' TO SEND YOUR COMPLETED FORM.