Young Person Details: This form should be completed by the parent / guardian for any Young Person under the age of 18. If necessary, the form can be completed by a nominated scribe.
This next section is mandatory- Please complete all field criteria.
Name of person filling out the form with legal responsibility for Young Person
Relationship to participant (Parent, Guardian, Social Worker)
Participants legal name (including any middle names)
"Participants preferred name (if different to the name above)
Address (participant)
Postcode (participant)
Participants Date of Birth
Confirm age at application (13-16 yrs)
Sex
Telephone
Primary Email
Preferred Cadet Unit
Emergency Contact 1: Name
Address
Email
Telephone
Emergency Contact 2: Name
Address
Email
Telephone
Consent: By signing this referral form you are confirming that you hold parental responsibility over the named child/young person, and you are consenting to South Wales Fire and Rescue Service (“SWFRS”) processing your and the child/young person’s personal data for the purposes of participating in the Fire Cadets.
Parent/Guardian acceptance
Medical Information: As a service we aim to be as inclusive as possible and can adjust our timetable / activities to accommodate requirements/conditions as necessary.
Parent/Guardian must complete each section below and provide details as required.
Does the applicant have any of the following?
Allergies to medications
Food Allergies/Coeliac disease or special dietary requirements
Asthma
Epilepsy/seizures
Diabetes
Fainting or dizziness
Hayfever
Travel Sickness
Bone, muscle or joint conditions
Other condition
Details of any current medication, name and dosage
I consent to my child receiving medication as instructed and any emergency treatment including anaesthetic or blood transfusion as considered necessary by the medical authorities present.
We would attempt to make contact with you before seeking treatment.
Yes No
Additional Information: Does the Young Person present as Neurodiverse?
Are there any adjustments needed to support them?
If ‘Yes’, please describe how below
Young Person must complete each section below and provide details as required. (Parent/Guardian can scribe for young person if necessary.)
What interests you most about becoming a Fire Cadet?
How do you think being a Fire Cadet will help you develop personally?
Are you prepared to commit time regularly to training activities as part of Fire Cadets to include charitable events and community engagement?
What hobbies and interests do you have currently?
Are you currently a member of any other clubs/youth groups?
Our Commitment to You: We understand that in some cases additional support may be needed to enable a candidate to participate fully in the Selection Process (e.g. dyslexia). Please record any support requirements that you may have in the space below. This information enables us to ensure that the necessary arrangements are made on your behalf. This detail is kept completely confidential and has no bearing on any selection decision.
Fire Cadets’ Code of Conduct: Fire Cadet Instructors are responsible for maintaining appropriate conduct amongst Fire Cadets. Instructors, Volunteers and Cadets represent the Fire and Rescue Service (FRS) and must remember their responsibilities to the community, ensuring courteous and professional behaviour at all times.
I confirm that I have read and understand the code of conduct and agree to comply with all of the above.
Cadet (applicant)
Parent/Guardian
Equal Opportunities: Sex
Gender identity - Is this the same as registered at birth?
Ethnic Origin
Sexual Orientation
Religion or Belief
Language – What is your main language
Are you a Welsh speaker?
You are welcome to communicate with us in either English or Welsh.
Our paperwork is available in either English or Welsh
