AL GHAZALI MULTICULTURAL CENTRE
35 Earle Road Liverpool
Tel: 0151 734 3843
Emergency Contact (Must be different from parent / guardian contact details)
Do you suffer from any Illness/ allergy/ disability?
I have read and understood, and understand that photographs may be
taken by the AYC staff which could be used on our promotional material *
I consent for my personal data in this form to be passed on to LCC and other organisations deemed
necessary for data analysis and I understand that I can withdraw my consent at any time *
If you have any questions or concerns, please speak to your youth worker.