Annual Parent/Guardian Consent Form
(Autumn 2022 - Summer 2023)

Dear Parent/Guardian,

We warmly invite your son/daughter to participate in our activity programme. Please complete this Annual Parental Consent Form to help us as we do everything we can to help them have a fun, safe and meaningful time.

If at any point you have any questions or concerns, please contact your local YL staff person or follow our Resolving Concerns and Complaints Guidance.

We look forward to seeing your son/daughter soon!

The Young Life Ireland Team.

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What does this Parent Consent Form cover?
All clubs, connect groups, events and activities lasting one day or less throughout this current academic year. Your local YL team will release information about the dates, times, &locations our of key activities on our social media handles as well as our Parents/Guardian WhatsApp group chat.

You will be asked to sign a fresh Parent/Guardian Consent Form for any higher risk activities, overnight trips, multi-day events (Such as Spring/Summer Camp).

Young Person's Details
1. Full Name of Young Person *
2. Young person's Date of Birth *
3. Young Person's Home Address *
4. Young Person's Eire code
5. Young person's School/Education *
6. Young person's school year *
Parent/Guardian's Details
7. Full Name of Parent/Guardian completing this form *
8. Parent/Guardian's Phone Number *
9. Parent/Guardian's Email Address *
10. If you're unavailable, who can we contact instead? *
11. Their home address (if different to the your son/daughter's address)
12. What is their relationship to your child?
13. What is their phone number?
Medical Details
14. Name of Doctor (or Doctor's surgery) *
15. Address of Doctor *
16. Phone number of Doctor *
17. Does your young person have any allergies/dietary requirements?  If yes, please explain, including the severity of requirements (ie: "my daughter is gluten intolerant so she avoids food with gluten"  or  "my son has severe Celiac Disease and cannot have any contact with gluten whatsoever"
18. Any current or recent medical details we should be aware of (including any contagious or infectious diseases that your son/daughter has suffered from in the last 3 months).
19. Does your son/daughter have any additional support needs that we should be aware of? Please give details, if necessary.
20. Details of any medication your son/daughter is currently taking, the dosage and whether it can be self-administered.
21. Is there anyone in your son/daughter’s household who is considered by themselves or the Government to be "clinically extremely vulnerable"? *
22. If needed, are you happy for YL staff/volunteers to give your child: *
23. Date of last anti-tetanus injection (if known)
Consents & Commitments
24. I give consent for YL staff/volunteers to contact my son/daughter as part of their youth work duties, via the following electronic means and in accordance with our Electronic Communications Policy (available upon request). Please select all that apply. *
Text message
Phone call
Social media
25. If you selected "text message" or "phone call", what's your son/daughter's phone number?
26. If you selected "social media", please list which platforms you're happy with us using (Instagram, Facebook, Any, etc.) [Note: In the interests of safety, YL leaders will not use Snapchat to communicate with your child]
27. If you selected "email", what's their email address?
28. I give consent for photos and videos to be taken of my son/daughter throughout any current and future activities with Young Life Ireland or Young Life International, which may be used on Young Life owned websites, social media and other online or offline fundraising and publicity material, according to our Electronic Communications Policy. *
29. Would you like to be added to a Parent/Guardian WhatsApp chat used to inform you about upcoming Young Life events and activities? (We will use the mobile number provided above) *
30. Are there any activities which your son/daughter may not participate in?
Parent's Declarations
Part A – Covid-19 Declarations

1.     I am aware of the risks posed by Covid-19 and am comfortable with YL Ireland's ongoing approach to managing the impact of the virus within youth settings, in accordance with government guidance. I will not let my young person attend any YL Ireland in-person event or meet-up if they are ill with Covid-19 or are otherwise self-isolating due to the virus.

Part B – Contingency Measures

2. In case of injury/illness, I give permission for a trained first-aider (where available) to administer first aid to my son/daughter as the first-aider considers necessary in the best interests of my child.

3. In an emergency, if I cannot be contacted, despite all reasonable attempts to do so by the leaders, I give permission for my son/daughter to undergo any medical/dental treatment, including the use of anaesthetics and blood transfusions, as considered necessary by the medical authorities. I acknowledge that any medical costs are my responsibility to settle.

4. I expect my son/daughter to behave in a manner that will not cause concern to YL staff/leaders, that even though they will give the utmost priority to the safety of the young people in their care, they cannot be held liable for behaviour that leads to accident, injury, or increased health risks to others. I understand that if my son/daughter misbehaves, the organisers may forbid them from further participation and require me to collect them at my expense. If they cause deliberate damage to property, I agree to pay for the cost of replacement.

5.   I understand that Young Life has a zero-tolerance approach to alcohol; weapons; and illegal drugs, solvents and substances. I consent to my son/daughter being sent home from any activity according to our Prohibited Items Policy if there is reasonable suspicion that my child is carrying such prohibited articles.

Part C – Other Necessary Declarations

6. I understand the nature of the activities and associated risks and that the programme may include a brief Christian message. I give consent for my son/daughter named on this form to attend the event and fully participate, including any off-site excursions, except for any elements of the programme which I have listed above. I am aware that I can opt my child out of attending any aspect of our programme at any point, by contacting my local YL staff person.

7. I confirm that I am the parent/guardian of the Young Person(s) named on this form and therefore have full legal authority to make these Declarations.

8. I understand that I am solely responsible for ensuring my son/daughter travels to and from each event, activity and meetup safely and on time, and in accordance with any transport expectations that are communicated by the YL event organisers. The only exception is where prior arrangements have been made with me by YL staff/volunteers to pick up/drop off my child, in accordance with the YL Driving Young People Policy (available upon request).

9. I consent to Young Life Ireland processing the personal data related to my son/daughter participating in YL in-person activities, meet-ups and virtual events as defined above and in order for YL to fulfil our Covid compliance obligations. I understand that all data which I provide you will be handled confidentially and held in accordance with applicable data protection legislation (including the General Data Protection Regulation). 

10.    If at any point I have any questions or concerns, I will seek to address these as soon as possible by resolving them informally with my local YL Ireland staff person or volunteer. I am aware that I can follow the YL Ireland Concerns and Complaints Guidance at any point if I feel that a more formal process is appropriate.

31. By typing my name in the box below, I agree that the information and declarations made in this form are true and correct. *
32. Date you completed this form
Do you have other young people to sign up?
If there are other young people you have parental responsibility for, please register them using the link on the confirmation screen.
Thank you for filling this in!
We care about your data privacy – find out more by reading our Privacy Notice:

Young Life Ireland is a trading name of Young Life, a company limited by guarantee (company number: 638610), registered in the Republic of Ireland. Registered office: 388 North Circular Road, Phibsborough, Dublin 7, D07T2R1.
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