Activity Registration and Consent Form

Activity Registration and Consent Form

Activity Registration and Consent Form

1. Child/young person’s details

Name
Address
DD slash MM slash YYYY
Gender
Are there any activities in which your child can not participate?

2. Parent or Carer's details

Name
Address

3. Emergency contact information

4. Child’s medical details

Are three any specific medical conditions requiring medical treatment?
Are there any other medical conditions or disabilities to be aware of?
Do they have any allergies?
Are there any dietary requirements (including vegan / vegetarian)?

5. Any extra help we need to provide (for example because of a disability)

6. Photo and video consent

I agree to (please tick)

Consent Information: Consent lasts for three years from when given. Consent may be renewed.

DD slash MM slash YYYY
DD slash MM slash YYYY

7. Consent

Greater Manchester Youth Federation aims to provide a safe and enjoyable experience for every child or young person. To help us to do this, please note the following important information: • All questions on the consent form must be completed and signed by the parent or carer before any child takes part. • Parents and carers must ensure they notify us of any changes to the information given on the form. • Parents and carers must make arrangement for primary school aged children to be brought to and from the Junior Youth Club safely and on time. If a parent or carer is not able to collect their child, they need to let us know in advance who will be doing so. • We cannot take responsibility for any damaged clothing and/or personal items during the youth club. • Greater Manchester Youth Federation’s Safeguarding Policy can be found https://gmyouthfed.org/safe-guarding-policy/

Declaration of consent – Parent / Carer

I agree to (Please tick the boxes below and then sign this form)
I agree to (Please tick the boxes below and then sign this form)
I agree to (Please tick the boxes below and then sign this form)
I agree to (Please tick the boxes below and then sign this form)
Print Name
DD slash MM slash YYYY

Right to withdraw consent:

You have a right to withdraw your consent at any time. If you wish to do so, please contact Lee Adams Youth Activities Leader email. [email protected]