NCS Parental Consent Form Feb 2017

    Young Person Personal Details

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    Medical History - Childs Information

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    Has your child ever been in trouble with the police (history of offending)?
    Does your child have a special needs statement?
    Is your child blind or partially sighted?
    Is your child deaf or hearing impaired?
    Is your child a wheelchair user or have mobility difficulties?
    Is your child on the autistic spectrum or has Aspergers syndrome?
    Does your child have mental health difficulties
    Does your child have a history of truancy?
    Are there any concerns around self harm/eating disorders/anxiety or depressions?
    Are there any issues around substance misuse?
    Is your child a parent (including pregnant)?
    Is your child a young carer?
    Are you in or recently been in local authority care?
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    Swimming ability

    Is your child able to swim?
    Is your child able to swim 50 meters?
    Is your child confident in a pool?
    Is your child confident in open water?
    Is your child safety conscious in water?
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    Further Information

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    Times and dates are arranged so that you won't miss any school/college. If you think you may, please contact us and we can clarify. February residential leaves Friday 17th February 2017 and will be back on Monday 20th February 2017.
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    Parental Consent Agreement

    Please the read the points below carefully.
    To attend and take part in the NCS programme with Warrington Youth Club
    I give permission for photos and filming to be used for marketing or publicity purposes, including WYC Social Media
    I understand that the fee for the programme (£35) is non refundable once paid
    I understand that whilst safety is a major concern, it can often only be maintained if my child adheres to the conditions laid down by members of the staff team.  Therefore, if he/she fails to adhere to such instructions it could create a potentially dangerous situation for themselves and others, then I am aware that the programme and its staff may find it necessary to transport my child home at their/my own expense.
    I understand that there are strictly no drugs or alcohol allowed on NCS and if my child is found with or suspected of having or have consumed drugs or alcohol they will be removed from the programme.
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    Payment Details

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    Thank You for completing this form!