Safeguarding & Child Protection

Child Protection Policy

Parental Consent Registration Form

Young Persons Details

Name

First Name

Last Name

Address Line 1

Address Line 2

Town/City

Postcode

Young Person's Phone Number

Date of Birth

Day/Month/Year

YYYY

School

Year Group

Parents Details

Name

Home Phone Number

Mobile Phone Number

Permissions

I give permission for my son/ daughter/ to attend the Soul Survivor Watford Youth Events during the year September 2018-2019 in the charge of the Soul Survivor Watford Youth Team. I give permission for my son/daughter to be photographed or filmed and the pictures and film footage used for SSW publicity/SSW film presentations. These photos/films are kept under a password access. I give my consent to any medical treatment that may be required in an emergency by either a qualified medical practitioner or a qualified first aider. I will inform the youth team of any changes to the medical information supplied overleaf. If you are over 18 you can sign this form for yourself, but only for yourself.

Medical Information

Does he / she suffer from any on-going or recurring illness?

Does he / she take regular medication?

Does he / she have any known allergies, phobias or disabilities?

Please include allergies to all types of medication:

Has he / she been immunised against Tetanus within the last 10 years?

Does he / she have any special dietary requirements (eg. vegetarian)?

If yes, please state:

In the event of any 'homely' medication (eg. paracetamol, cough mixture, antacid) being required please state which you will permit to be given:

Can he / she swim 25 metres?

Is there any personal information the SSW should be aware of?

If so, please state:

Please give details below of your GP:

Doctor's Name

Address

Postcode

Phone Number

Note: The medical profession takes the view that a parent's consent to medical treatment cannot be delegated. This view is explicit in the Children Act 1989. Medical consent forms have no legal status and a doctor has the right to insist on parental consent to treat a child. However it can be of comfort to medical staff to have general consent in advance from parents or have a leader on hand to sign forms.

Safeguarding & Child Protection

Child Protection Policy﻿

Child Protection Policy