Volunteer Registration | Maternity Champions

Contact Details

First Name *

Surname *

Address

Postcode

Telephone number *

Email *

Personal Information

We are required to collect this information as part of our funding conditions. All information is confidential and only used for monitoring.

Date of Birth

Gender

Sexual Orientation

Age

Ethnicity

Asian, Asian British or Asian Welsh

Black, Black British, Black Welsh, Caribbean or African

Mixed or Multiple ethnic groups

White

Other ethnic group (please state below)

Other ethnic group

Languages Spoken

Other Languages Spoken

Employment Status

Are you

Unpaid Carer
Asylum Seeker
Refugee

Do you consider yourself to have a long-term health condition or impairment

Yes

No

Long term health condition or impairment

Are there any reasonable access/support arrangements we can put in place to ensure you can volunteer? (please state below)

Emergency Contacts

Please provide details of TWO emergency contacts. By providing their details below you are confirming that these contacts have agreed to act as an emergency contact for you.

Emergency Contact 1

Name

Contact Number

Relationship to you

Emergency Contact 2

Name

Contact Number

Relationship to you

Gerneral Permissions

Photography

Please read and sign the attached Photography Permissions to indicate your photography preferences.

Use of personal data

Regulation, known as the ‘GDPR’, became the law. These laws outline the governance for processing and storage of personal data, and cover both paper-based as well as digital records. Blossom’s Harrow Maternity Champions Project take privacy and security of personal data very seriously.

While you are registered as a Maternity Champions volunteer your details are kept on digital file. Any paper files are securely locked away with access given only by the permission of the Maternity Champions Co-ordinator. No details that would identify you as an individual are passed to any third party without your prior consent.

As part of our funding requirements, we will share aggregated data on our volunteers to our funders. This data is anonymous, and it will not identify you as an individual.

All information remains the ownership of the volunteer and will be securely destroyed once you leave the project. We will retain details for funders, but remove your personal contact information from the record.

For further details of what we store, why we are storing it, and how long we store it for, please refer to Blossoms ‘Privacy and Cookies Policy’ which can be found on www.maternitychampions.com/privacy-policy.

How did you hear about Maternity Champions?

To help us with our marketing can you please tell us how did you heard about becoming a Maternity Champions volunteer?

Please select as appropriate

Other

Constent

By submitting this form, you are confirming that you have supplied the correct information, and read, understood and agree to all the permission requests in the registration form. If you have any questions prior to completing please speak to the Blossom's Maternity Champions Volunteer Co-ordinator.