Page 1 of 1

Aotearoa Youth Declaration 2026 - Rotorua Regional Engagement

First Name/Tō ingoa tuatahi?

Last Name/Tō ingoa whānau?

Email/Tō īmēra?

Phone/Tō nama waea?

Date of Birth/Tō rā whānau?

What year of school are you in?/Tō tau kura?

What school do you go to?/Te kura e haere nā koe?

What suburb do you live in?/Te paenoho e noho nā koe?

Ethnicity/Tō mātāwaka?

Ethnicity/Tō mātāwaka?

Gender/Tō ira?

What are your pronouns?/Ō tūkapi?

Do you identify as LGBTQIA+, takatāpui, or MVPFAFF+?/E tohu
ana tō tuakiri ki te LGBTQIA+, takatāpui, MVPFAFF+ rānei?

How did you learn about UN Youth?/I pēhea tō mōhio mai ki tēnei kaupapa?

How did you learn about UN Youth?/I pēhea tō mōhio mai ki tēnei kaupapa?

Would you like to subscribe to our mailing list?/Kia tūhono mai koe ki tā mātau rarangi tuku īmēra?


Do you have any dietary requirements?/He hiahia ā-
whiringa kai rānei, ā-mate pāwera rānei āu?

Do you have any medical requirements?/He hiahia ā - hauora
āu?

Do you have any accessibility requirements?/He hiahia ā-urupai
āu?

Is there anything else we can do to improve your experience?/Ngā āhuatanga hei whakapai ake ī tō wheako?


Alternative Contact Name/Te ingoa o tō hoapā
ohotata?

Alternative Contact Phone/Te tūranga īmēra me te nama waea o tō hoapā ohotata?

Relationship to Alternative Contact?/Tō piringa
ki tō hoapā ohotata?


Terms and Conditions

Your attendance at a UN Youth event or programme is also bound by certain conditions unless otherwise stated. You must provide us with an alternative contact When registering or applying for an event or programme, we require the details of a parent, legal guardian or emergency contact. In the event of an emergency at one of our events or programmes, UN Youth will communicate with your alternative contact. You can update this contact at any time and you can change it for each event you attend. Privacy Notice

To enhance our capacity to offer relevant event opportunities, UN Youth may collect and store your name, mailing address, and other non‑sensitive personal information for the purposes of marketing, administering, delivering, and improving our programmes and events.

Your personal information will be stored securely using reasonable safeguards and retained only for as long as it is required for these purposes, in accordance with the Privacy Act 2020.

Where relevant to the delivery, funding, evaluation, or reporting of events or initiatives, UN Youth may share identifiable personal information with Rotorua Lakes Council (RLC). Any such sharing will be limited to information reasonably necessary for those purposes, and RLC will be expected to handle the information in accordance with the Privacy Act 2020.

UN Youth will not otherwise disclose your personal information to third parties without your consent, unless required or permitted by law.

You have the right to request access to, correction of, or deletion of your personal information at any time. Requests will be handled in accordance with the Privacy Act 2020.

Abridged code of conduct I agree to the UN Youth New Zealand Code of Conduct, which is linked below.
The key principles are that: - I am respectful and tolerant of all backgrounds. - I will not engage in bullying or harassment. - I will respect other people's opinions, and will not promote hateful opinions. - I will act in a manner that promotes health and safety throughout the event. (For example, I will not consume alcohol or illegal drugs during the event, or engage in actions that endanger others). - I respect the role and status of te ao Māori. - I accept that any violation of the Code of Conduct can result in my immediate removal from the event, and can result in a permanent ban from events run by UN Youth New Zealand. Certain UN Youth documents and protocols apply to you In addition to these conditions, you and UN Youth are bound by:
- the National Constitution of UN Youth New Zealand - the Welfare Protocols of UN Youth New Zealand, and the Code of Conduct - our Privacy Policy Media release

By submitting this registration, I consent to UN Youth New Zealand capturing my image, likeness, and voice in photographs, video recordings, and other media (“footage”).

I grant UN Youth New Zealand a perpetual, royalty‑free, non‑exclusive right to edit, reproduce, publish, and distribute this footage, without compensation, for lawful purposes including (but not limited to) promotion, publications, digital content, media, reporting, and stakeholder or funder communications. This includes the right to share footage with partners or funders such as Rotorua Lakes Council.

This consent remains in effect unless withdrawn by me in writing by contacting privacy@unyouth.org.nz. Withdrawal of consent will apply prospectively and will not affect footage or materials already created, published, or relied upon.

If I am under 18 years of age, I confirm that this consent has been provided by my parent or legal guardian.

Terms and Conditions
Parental Acknowledgement

I, the participant named on this form have read and agreed to the Terms & Conditions of Participation outlined above.

Signature