Takeover Day – 12th November 2010 Registration Form Please tell us your plans for Takeover Day 2010 so that we can keep up to date with all the activities. Name: Angela Longrigg Job Title: Volunteer Co-Ordinator Directorate/Organisation: Phone Number: Action for Children 01900 706149 Email: angela.longrigg@actionforchildren.org.uk Date/s of event and location/s: Thursday 11th November 2010 at The Minto Centre, Nilsson Drive, Workington & Friday 12th November 2010 at the Cockermouth Children’s Centre, South Street, Cockermouth On Takeover Day, in our organisation children and young people will……take part in 2 different workshops based on the work carried out in Children’s Centres culminating in a ‘Question Time’ Panel discussion at the end of the day. What is hoped to be the main outcome for your service? To raise awareness of Children’s Centres and Volunteering opportunities at the Children’s Centres managed by Action for Children. How are children and young people going to be involved in the organising of the takeover? I would like to request the following: (please take all that apply) To be included in any Takeover Day news release from Cumbria County Council. Please fill in Section 1 below To arrange a photo call. Please fill in Section 2 below To be included on the Takeover Day webpages on the Cumbria County Council website. I am happy to be contacted again about further participation and engagement opportunities involving children and young people. Section 1 – to be included in a news release from Cumbria County Council Who would be able to give a quote for the news release? Rachel McQuilliam@actionforchildren.org.uk Who needs to give final clearance of the news release? Rachel McQuilliam Section 2 – to arrange a photo call Date: Time: Please give full details of the purpose of the photo call/ who needs to be in the photograph (NB – if children are involved, parental/guardian consent will be required unless the school/setting already has it) IMPORTANT Please can you confirm you have the following (please tick): Risk Assessment (written or otherwise) Appropriate insurance Permission from school/club/parent/carer Emergency contact details for young person/s Ensured all those taking part have considered the Child Protection guidelines Please return this form by email to rebecca.whent@cumbriacc.gov.uk, or post to Children’s Services, New Oxford Street, Workington, Cumbria, CA14 2LW.