Consent form

Young Person's Details

This form is to be filled in by any parent or carer who wishes their child to attend activities managed by Bridgnorth Youth & Schools Project. The data provided on this form will be held by Bridgnorth Youth & Schools Project. It will not normally be disclosed to any other third party and will only be used to assist in managing activities effectively and safely, and to fulfil safeguarding responsibilities.

Parent/Carer Section

ADDRESS OF PARENT / GUARDIAN DURING THE RESIDENTIAL IF DIFFERENT FROM THE CHILD’S ADDRESS ABOVE:
Please provide the most accessible phone number

Medical Information

Please fill in as much as you know about the surgery you attend.
Please give details of any disabilities or medical conditions of which we should be aware
Please give details of any special dietary requirements

Consent

If you’re concerned about any of these, please come to speak to us.
THIS SECTION MUST BE SIGNED BY THE PARENT OR OTHER ADULT WITH PARENTAL RESPONSIBILITY.
THIS SECTION MUST BE SIGNED BY THE ATTENDING YOUNG PERSON IF THEY’RE OVER 13 YEARS OLD.