Youth Consent Form
For the collection of personal parent/guardian information regarding email and text consent, and/or the child check-in system and Friday Youth consent. This data is solely for the use of New Life Christian Church Emsworth and will be stored in our secure database.
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Child First Name *
Child Surname *
Child Gender *
Child Date Of Birth *
Child School Year *
Child's Phone Number
Any medical conditions, including dietary needs or allergies? *
Please enter N/A if this does not apply
Any medication the young person carries? (Eg asthma pumps/diabetic medication)
Any instructions to follow in an emergency?
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I consent to my child receiving emergency medical treatment (if required) *
Any social, emotional, behavioural or mental health needs? *
Please provide details and strategies for managing this
I consent to my child taking part in New Life Youth activities, including Friday night meetings, social events and life groups *
I consent to the youth team contacting my child about New Life Youth via the weekly text system. I understand I can withdraw this consent at any time. *
I consent to my child using the skate ramp. (By ticking this box, you also agree and sign the waiver found at *
Consent for when leaving the site *
Do you have another child to add? *
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