Young Persons Information *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Have you attended AYD100 before? *

Yes

No

Parent/Caregiver Information *

First Name

Last Name

Phone *

(###)

###

####

Is the young person entitled to free school meals?

Yes

No

Not Applicable

Do you receive Universal Credits?

Yes

No

Not Applicable

Discount required (early bird ticket £65)? *

To ensure that as many young people have the opportunity to attend AYD100 we have various funding options and kindly ask that you consider what you can afford and tick the relevant box. Thank you.

25% (£48.75)

50% (£32.50)

£25 ticket

Require an alternative option