Memory Walk - Young Volunteer Consent Form 2026

Consent Form

Volunteers aged 16-17 must complete a volunteer registration form to volunteer at a Memory Walk event.

In addition to this, their responsible parent/guardian must provide consent by completing this form.

To find out more about how we use your personal information please take a look at our volunteer privacy statement.

Young person details

Please enter the details of the young person who will be volunteering at Memory Walk.

First Name *

Age at the time of volunteering *

Address Line One *

Address Line Two

Town/City *

Postcode *

Mobile number *

We'll use your email address to send you important information about volunteering at your Memory Walk.

Please select which Memory Walk the Young Person will be volunteering at *

Parent/Guardian details

Please enter your details below.

Last name *

Phone number *

Email *

Conditions

Please tick below to confirm you have read and accept the following conditions.

I understand that volunteering will be confined to the activities listed in the role description. If this changes, I will be asked to provide further consent. *

You can view the role descriptions on our Volunteering webpage here

I understand that appropriate public and employer liability insurance is in place to protect this young person whilst volunteering. *

I understand that all reasonable steps will be put in place to protect the health and safety of this person, including close supervision and risk assessment. *

Should there be any changes to my personal consent, or changes that affect the ability of this young person to volunteer, I will notify the event organiser as soon as possible (0300 330 5452 or [email protected]). *

In the event of illness, having parental/guardian responsibility for the above-named young person, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitable qualified medical practitioners. If I cannot be contacted and the young person should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication. I understand that in such an emergency I will be contacted immediately using the contact details above. *

Additional information

Details of any support needs, medical conditions, allergies or considerations for the young person.

In addition to my consent, I note below any extra information that may be useful (e.g. GP name and contact, names of additional family members that may, or may not, make contact with the young person etc.) *

Declaration

I give permission for the young person named above to be an Alzheimer's Society volunteer. *

Date *

Thank you for choosing to support us

We'll be in touch with more information soon. We’d love to keep in touch to show you the enormous impact you’re making. And we’d also like you to be the first to hear about the important research breakthroughs you’ve helped fund, our latest campaigning and fundraising initiatives, as well as the services we offer and any volunteering opportunities you might enjoy.

Yes - contact me via phone

Yes - contact me via email

Yes - contact me via SMS

Yes - contact me via social media

Please do not contact me by:

post

Connection to Dementia

Which of the following statements best describes your connection to dementia?

Person with dementia

Carer

Former carer

Relative/friend

Former relative/friend

Professional interest

General interest

Memory Walk- Young Volunteer Consent Form 2025

Consent Form

Young person details

Parent/Guardian details

My Address

Conditions

Additional information

Declaration

Thank you for choosing to support us

Connection to Dementia

Memory Walk- Young Volunteer Consent Form 2025

Consent Form

Young person details

Parent/Guardian details

My Address

Conditions

Additional information

Declaration

Thank you for choosing to support us

Connection to Dementia

Create a team

Join a team

Invite your friends

Create a Team

Optional...invite more friends