DofE Participation Enrolment Form You must complete all of the questions DofE Level BronzeSilverGold Have you registered for any previous levels of the DofE? YesNo If YES, please give the name of the DofE Centre you were registered at eDofE ID number (if known) Personal Details First Name Last Name Gender MaleFemale Date of Birth Primary Language EnglishWelshOther Date you wish to start your DofE programme if known (enrolment date) When you first sign in to eDofE you will be asked to record some personal details, such as your contact details, ethnicity and personal circumstances along with details of any medical needs you may have. This data is used to enable your Leaders to support you doing your DofE programme and for the DofE's statistical and reporting purposes. You will always have a 'prefer not to say' option. Contact Details Email address for Participant (essential to eDofE participation and one that is used regularly) Address (line 1) Address (line 2) Town/City County Postcode Telephone Mobile Emergency Contact Details Emergency contact name Relationship to you Emergency contact telephone number(s) Declaration Consent to enrol as a Participant I agree to enrol as a participant on a DofE programme. I understand that I will be managing my programme using the online eDofE system. I acknowledge that this system has a set of terms and conditions that I agree to. These terms and conditions are available at www.edofe.org. Consent to enrol from Parent or Guardian (if applicant is under 18 years old) I agree to my son/daughter/ward doing a DofE programme. I note that it is my responsibility to check that any activity that my son/daughter/ward undertakes for their DofE programme is appropriately managed and insured, unless the activity is directly managed or organised by their DofE group, cente or Licensed Organisation. Fees I agree to submit total enrolment fee via BACS (Bank Ref MUST BE surname of participant. Sort code 30.98.97 (Lloyds) A/C 47830260) OR by cheque made payable to Gillingham DofE OAC Bronze/Silver: total = £35 (£21 of which goes to The Award and £14 to DCC for admin and support) Gold: total = £45 (£28 of which goes to The Award and £17 to DCC for admin and support) This includes Welcome Pack, Discount Card, Enrolment into The Award Scheme Ltd, DCC support and admin which continues until the level enrolled for is completed. Participants, once enrolled can transfer their enrolment to other Units. Note Data supplied on this form and in eDofE and information about DofE activities recorded in eDofE will be used by the DofE Charity, the Licensed Organisation and DofE Centre to monitor and manage DofE participation and progress by young people and manage and support Leaders. The DofE Charity will use personal data to communicate useful and relevant information to either help participants complete a DofE programme, Leaders/LOs to run DofE programmes more effectively or help the DofE Charity to improve the quality and breadth of its programmes. Occasionally the DofE Charity may send you information relating to commercial offers. If you do not wish to receive commercial information from the DofE Charity you can choose not to by amending your contact preferences in your eDofE profile at any time. Please enter your name below to electronically sign this document Please indicate if you are signing this document as a Parent/Guardian or a Participant ParticipantParent/Guardian Please leave this field empty.