NCS Parental Consent Form Summer 2018

    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 50 meters?
    Is your child confident in open water?
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    Wave preference

    There are limited spaces on each wave and these spaces will be given at a first come first serve bases. *****Your place is not confirmed until you have paid £50. *****
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    Parental Consent Agreement

    Please the read the points below carefully.
    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 (£50) 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!