BEACH TRIP CONSENT FORM

Parent/Guardian Consent

We are seeking consent/permission for the below named young person, to participate in our trip to Porthcawl on THURSDAY 22ND AUGUST.

Your young person is expected to be at Community House at 10.30am for the bus and will return around 6pm.

Youth workers numbers: Ellyse: 07709776783 Mark: 07918533669 Louise P: 07824394291 Louise A: 07918533666 Mollie: 07719180640

All activities will be organised and supervised by qualified and vetted staff, from the project. All routes have been risk assessed and checked for safety. There is no cost for the Activity.

Young people need to bring:

- A bottle of water,

- Suncream,

- Swimwear and change of clothes (if going in the sea)

- Spending money if they want to (the trip is free and food will be provided)

Young person's name

Full name of your child

First Name

Last Name

Young Person's Date of birth

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parental Guardian's Name

First Name

Last Name

Relationship to child (Mum/Dad/ Step/ Carer/ Guardian)

Phone number of guardian

(###)

###

####

Do you give consent for your child's photo's/videos to be shared for marketing purposes?

In accordance with our child protection policy, we will not permit photographs, video or other images of young people to be taken without consent. If the child is under 16, consent must be obtained from a parent / carer. Community House will take all steps to ensure these images are used solely for the purposes for which they are intended. If you become aware that these images are being used inappropriately, please inform us immediately. You can do so by emailing sarah.miller@etonrdch.org or calling 07746440761 Best wishes,

Yes

No

Medical conditions

Please tell us if your child has any medical conditions i.e asthma, allergies, necessary medication

With thanks to all our supporters, past and present