Online Membership form
To become (1) or (2) you will need to be resident within our area of benefit. To become (3) you do not need to live within our area of benefit but you must make a commitment to help us deliver our services and activities as a volunteer. RPTB’s area of benefit covers the Regents Park Ward and its immediate surroundings within the London Borough of Camden.
RPTB reserves the right to request references and obtain a DBS check as part of our safeguarding policy and procedures to protect vulnerable adults and young people.
Personal Details
Surname:
First Name:
Tel. No (home):
Tel. No (work):
Tel. No (mobile):
Email:
D.O.B:
Address:
COMMENTS: Please inform us of any mobility, physical or mental health issues you and or your children have. Please note all information given is strictly confidential.
Other
If you have children that you are the parent or the legal Guardian you must add their details:
Please Note: Only children under 12 years of age can take part in RPTB’s family activities.
1. CHILD’S NAME
1. CHILD’S AGE
2. CHILD’S NAME
2. CHILD’S AGE
3. CHILD’S NAME
3. CHILD’S AGE
4. CHILD’S NAME
4. CHILD’S AGE
References. Please can you provide two names, addresses and telephone numbers of people who know you ie a member of the family, a friend, a colleague. This is so we know that as a Time Bank participant you and your family are safe so for everyone involved in the scheme.
1st Person Name/Address/Tel No.:
2nd Person Name/Address/Tel No.:
What Skills and Interests will you Share ?
What help and support you are looking for?
Regents Park Time Bank ground rules:
As a participant of the Time Bank I agree to:
Give my time to help others and provide practical help and support in the running of the Time Bank’s self-help groups, community services and social events.
Respect another participant’s privacy or confidentiality
Respect other participant’s viewpoints, and to not pressure another participant to accept my religious beliefs or political views.
Not involve my friends or relatives in time bank activities by bringing them to a participant’s home or venue of time exchange, unless agreed with the Time Bank as being part of a group activity.
Not ask for or accept money, gifts or tips from other participants.
Always treat other participants respectfully. We do not accept any type of bullying or harassment including physical, verbal or emotional and in such instances the persons involved will be spoken to and if continues they may be excluded from the Time Bank.
The Time Bank maintains a photographic and video record of the activities undertaken by participants. These may be used in our newsletter and for general publicity, including on our website. I give my permission for photos to be used for Time Bank publicity.
I agree to abide to the above ground rules
Name
Date
To become a full voting member of the Time Bank and a shareholder (max liability £1.00)
you will need to be proposed and approved at a Committee of Management Meeting (bi monthly)
All Time Bank members will be bound by the Regents Park Time Bank’s policies and procedures.
Confidential
The Regents Park Time Bank requests this information for purposes of ensuring that we are able to monitor our equal opportunities policies and procedures so that people of all ethnic origins and backgrounds have access to joining the Time Bank.
Ethnic Origin (please tick)
Other Asian
Other Black
Other group
Other mixed
Other white
Submit
