Consent Form | Abbots Cross Congregational

Christ Church Congregational, Abbots Cross

Parental Consent Form

Any details provided on this form will be held in confidence.

We need these details in order to meet the specific needs of your child.

Please indicate which organisation/s your child attends

Youth Club

Girl's Brigade

Boy's Club

Child's full name

Birthday

Day

Month

Year

Address

Name of parent/guardian

Phone

Please indicate medical conditions, additional needs, allergies or dietary requirements relevant to your child.

Do you give permission for images to be taken of your child and used for our social media pages?

Yes

In the event of illness or accident, I give permission for first aid to be administered by a qualified first aider.

In the event of a medical emergency we will endeavour to contact you as soon as possible. However, if we cant contact you this form will give us permission to accompany your child to hospital if required.

I will inform the leaders of any changes to my child's health, medication or needs and also of any changes to contact details given above

Signature

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Date signed