Companion Application Form | Youth Cancer Trust

Complete the full Companion application form.

As a companion coming on holiday with a Youth Cancer Trust guest, please complete this form so that staff have all relevant details to provide a safe and comfortable break for you. If you are under 18, your parent/guardian must complete this form with you.

Once the form has been received, a member of staff will be in touch to confirm.

Things you need to know:

  • Travel will be arranged through the YCT guest
  • Approximately 2 weeks before the holiday, both you and the YCT guest will be invited to a Zoom meeting to meet staff and other guests
  • More information will be emailed to you seperately.

 

Things you need to know

  • We call our young people ‘ GUESTS’ .
  • Guests are able to bring a COMPANION with them on holiday (sibling, friend, partner of a similar age) they are called COMPANION guests.
  • We provide online support for GUESTS only
  • Staff are not medically trained
  • We have confidentiality and safeguarding policies
  • We operate flexibly in office hours 8.30 – 5. 30. When there is an evening or weekend activity we work at the hours specific on the event.

    Companion Application Form

    Who’s completing the form:

    Guest details and information

    Personal Information

    Please upload a photo of yourself so we can recognise you if we need to collect you and so our chef knows who you are if you have any particular dietary requirements. If you are unable to upload your photo, please email it to laura@yct.org.uk

    Contact Details

    How do you prefer to be contacted

    Emergency Contact

    We take the wellbeing of our guests very seriously. Should we have any concerns about your health and wellbeing whilst participating in our online programme we request that you can please provide us with an emergency contact. If you are under 18 this must be your parent/ guardian.

    Primary Contact

    Secondary Contact

    Equal Opportunities

    Companion considers their ethnic background to be?

    Companion's Religion

    *NB if you come on holiday you may want to let us know how we can support your religious practice

    Communication Needs

    Please let us know if you have any needs that might impact on our communication with you

    Criminal Convictions

    If you tick yes a member of staff will chat to you about it.

    Age

    Companion Information

    Medical Information

    GP

    Other conditions

    Allergies

    Asthma

    Epilepsy/seizures

    Diabetic

    Physical Abilities

    Mental Health

    Fatigue levels and 'brain fog' or memory issues

    These are some of the commonest symptoms our guests have to manage.

    Medication

    Please note you are responsible for your medication. There is a designated medical fridge on site for medication that needs to be kept refrigerated.

    Some prescribed medicines contain substances that mean they are called controlled medicines . You will probably know if you are on these and there are some laws around how they are stored. Common examples include morphine, diamorphine, methadone, fentanyl, alfentanil, oxycodone, methylphenidate, dexamphetamine, ketamine and tapentadol.

    In order to abide by the law and to ensure safety, staff will need to store these medications in locked cabinet and staff will support you to access your locked medications.

    There are other medications /injections such as Epipens or hydrocortisone injections or Midazolam that guests may need to carry on their person.

    Please state any specific needs around taking your medication.

    Please List Your Current Medicines:

    Over the counter medications will be available for over 18’s to request as long as they complete a medical disclaimer.

    Dietary requirements and preferences

    Our chef would like to know in advance your dietary needs and preferences.

    UNDER 18s

    I agree to (please tick):

    OVER 18s

    I agree to (please tick):

    Consent regarding photos and filming with Over 18’s will be asked on arrival.

    By clicking the 'Submit' button, you are confirming that all the information on this form is correct at the time of application.