St Brigid's Church Youth Activity Consent Form
Parental consent form for CONNECT youth events at St Brigid's Church.
CONNCECT is for 11-18 year olds and takes place on the third Sunday of every month from 7-9pm (excluding July and August).

You can contact the overall leader of CONNECT, Revd Jacob Mercer, on 07833462066. 

Safeguarding information for children and young people is displayed throughout our premises. You can access safeguarding information via our website: www.stbrigidsglengormley.org/safeguarding

Directions to St Brigid's can be found here: www.stbrigidsglengormley.org/contact-us 

We are committed to protecting your personal data. By completing this form you are confirming that you give your consent to St Brigid's to hold and process your personal data for the purpose of administrating this group and contacting you in relation to it, whether by post, phone or email. Your personal data will be kept secure and private, but there are certain situations in which we may be legally obliged to disclose ceertain data. To find out more, please see our Data Privacy Notice. This is a Google Form and Google's privacy notice can be viewed here. Information on how they comply with UK GDPR can be found here.
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電子郵件 *
Young person's name *
Young person's address (and postcode) *
Young person's age *
Young person's sex *
Parent\Guardian's name *
Parent's/Guardina's contact number *
Second person with responsibility for your child
In case you cannot be contacted
 *
Second person's contact number *
I give permission for my child to attend CONNECT meeting at the time and place specified above and confirm that he/she is willing to participate as fully as possible. It is my understanding that specific consent will be sought for any additional activity outside of the above days and times and venues.
 *
Please outline any medical or dietary information about your young person that we should be aware of 
e.g. allergies, asthma, epilepsy, medication, special needs, vegetarian, etc. 
 *
I give permission for basic first aid to be administered to my child/young person. *
In the case of an emergency, staff and volunteers will do everything reasonable to contact the parent/guardians named above. In circumstances where medical treatment is required immediately and where it is not possible to contact those named on this form, do you authorise the leader in charge of the group to refer your young person to a medical practitioner or emergency services on your behalf and to sign on your behalf any written consent required in the event of a life-threatening injury/condition?
 *
In accordance with Safeguarding Trust, our safeguarding policy, we must have your consent to take photographs and record video images of your young person. Photos and videos may be used on the church website and social media platforms, in emails, and in printed material, including local press and the Connor diocese magazine. Photos are stored securely and your consent to hold or use these images may be withdrawn at any time. Do you consent to St Brigid's taking and using photos and videos of your child?

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Signed
Please type your name below
 *
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