One Kids Brighton - Consent Form
For any child under the age of 18, we ask that a parent/carer completes this consent form in order for their child to participate in any children's activities run by One Church Brighton.

Please complete one form per child and update us if any of the information given on this form changes.

If you have any questions or concerns, feel free to contact Maddy, our Children's Worker, at maddy@onechurchbrighton.org, or on 07926984256.

We take safeguarding really seriously. Our policies, safeguarding team, and details of what to do in the event of a concern can be found online at onechurchbrighton.org/safe or by emailing safe@onechurchbrighton.org.

-Privacy notice-

We are collecting this information to enable One Church Brighton to keep in touch with you, to let you know what is happening and any activities that you might be interested in. We are also using this to gain your consent for your child to safely participate in our activities in line with our Safeguarding Policy. Your information won't be shared and will be held on our online database in accordance with our Data Protection Policy, our Privacy Statement, our Confidentiality Policy and our Data Retention Policy all of which can be found on our web page www.onechurchbrighton.org.  If you would like to see a paper copy please call the office on 01273 694746. If you are concerned about the way your information is being handled or you wish to notify us of a change to your information please contact Claire, our Data Protection Lead on 01273 694746 or email info@onechurchbrighton.org. We will make every effort to ensure that your concerns are addressed, however, you have the right to complain to the Information Commissioners Office.
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Child's details
First name *
Surname *
Date of birth *
MM
/
DD
/
YYYY
Current School Year *
Address *
Please provide the child's full address including postcode.
Medical Information
Having this information helps us ensure we are accessible to all. It's also vital information in case of accidents and emergencies. Please keep this up to date and as accurate as possible, and do get in touch if there's anything you wish to discuss further.
Name and phone number of GP *
Any specific dietary needs? *
(Allergies/intolerances, vegetarian, vegan, etc.) Please state "none" if nothing applies.
Any medical conditions? *
(Asthma, diabetes, disabilities, etc.) Please state "none" if nothing applies.
Any medication or treatment being taken regularly? *
(This is vital for emergency scenarios.) Please state "none" if nothing applies.
Any other information regarding accessibility
Specific needs, neurodiversity, accessibility, mental health or anything else that could help us make the sessions as safe and welcoming as possible.
Parent / Carer contact details
It is essential that contact details are given for a parent/carer who will be available in case of an emergency.
First contact
Contact 1 - Full name *
Contact 1 - Relationship to child *
Contact 1 - Address *
Please include postcode
Contact 1 - Home number
Contact 1 - Mobile *
Contact 1 - Email Address *
Second contact
The following queries are for a second contact, to be contacted if first contact is unavailable
Contact 2 - Full name *
Contact 2 - Relationship to child *
Contact 2 - Address *
Please include postcode
Contact 2 - Home number
Contact 2 - Mobile *
Contact 2 - Email Address *
Parent / Carer Declaration
• In the event of the named child becoming ill or injured, I authorise the leader present to administer first aid and accompany the child to the hospital if required.  If I cannot be contacted by telephone or other means to authorise this, I hereby give my consent to any medical treatment judged to be necessary and urgent by a medical practitioner, and I authorise the leader in charge to sign any document required by the hospital or other authorities.

• I give permission for the child named to attend any of One Church Brighton’s regular children's activities, including all on-site and local activities (we will notify you of any off-site activities) and online.

• I will make arrangements for my child to be brought to and from the activity safely and on time. If I am not able to collect my child, I will let One Church know in advance who will be doing so.

• I will inform the leaders of any important changes to my child’s health, medication or needs, and also of any changes to our address or contact details given above.

• I understand that my child needs to follow appropriate behaviour and safety rules so that One Church Brighton can keep them and other children safe.

• I understand One Church Brighton cannot take responsibility for any damaged clothing and/or personal items during children's activities.

• I understand it is my responsibility to ensure my child has sufficient water, food, clothing, sun lotion and medication (where appropriate) for the duration of One Church Brighton's children's activities.

• I agree that One Church Brighton may contact me by letter/phone/e-mail/text message.
Consent for participation *
Required
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