Fet-Lor Consent Form
In order for your child to attend FetLor, we must have some information.
Full Name *
Your answer
Age
Your answer
Date of Birth of Young Person *
MM
/
DD
/
YYYY
Address *
Your answer
Post Code *
Your answer
School *
Your answer
School year *
Parent/Guardian Name *
Your answer
Contact Number *
Your answer
Email Address *
Your answer
Emergency Contact Name (other than Parent/Guardian name) *
Your answer
Emergency Contact Number *
Your answer
Relationship of emergency contact to Young Person *
Does your child have any allergies or medical conditions that we should know about? (Eg: nuts, dairy, wheat, eating disorders, diabetes, epilepsy etc)
Your answer
Sometimes, photographs or video are taken to capture activities around the premises and often shared on social media. Do you allow your Son/Daughter to be photographed? *
Sometimes FetLor organise spontaneous activities in and around the premises. Please indicate if you are happy for your child to participate? (ie, fencing or judo) *
Is your Child allowed to walk home themselves at the end of each club? *
If no, please state who is authorised to collect your child? (maximum three people)
Your answer
Does your child have contact with both parents? *
If not, are there any restrictions in place?
Your answer
Is your child involved with/getting any support from any other agencies? Eg: social work, children and families. (This helps us to cater our services to better suit the needs of the young people)
Your answer
Does your child attend any other provisions within North Edinburgh?
Your answer
By competing and submitting this form, you are giving permission for your child to attend the provisions at FetLor Youth Club.
*All information will be stored in a safe, secure place and will not be shared and will be destroyed as soon as no longer needed.

*It is the parent/carer's responsibility to inform FetLor Youth Club of any changes to this form.

Our Child Protection guidelines can be found here: http://docs.wixstatic.com/ugd/2a134c_0e3512b9baeb434f924be9d50a0b25cf.pdf
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