Youth Consent Form

Young Person's Details

Please fill in young person's details. Complete one form per young person.

First & Last Name *

Date of Birth *

Sex

Mobile

Young persons mobile number

Young person's email address

Medical Condition or allergies *

Other relevant information about young person

School

Parent/Guardian Details

Please fill in the details for the parent / guardian

Parent/Guardian Name *

Parent/Guardian Relationship *

Parent/Guardian Email *

Parent/Guardian Mobile *

Address *

Emergency Contact Name

Emergency Contact Phone

Consent

Do you give consent for my child to walk home from Blackpool Church youth events without parental supervision? *

Do you give consent for your child to be in photographs & Videos for the purpose of Blackpool Church publicity? *

I give consent

Do you give consent for your child to be communicated with directly by DBS certified Blackpool Church team via official Blackpool Church platforms (no personal accounts will be used) *

I give consent

Signature

Please give consent for your young person in the below contexts.

I understand that I am giving consent for my child to attend Blackpool Church youth events, for first aid to be administered to my child when necessary and for parents/guardians/emergency contacts to be contacted about youth events. *

I understand

Blackpool Church will use your information for the purpose of Blackpool Church youth events and to keep on record in the event of an emergency regarding your child. If you would like to know more about how we handle your details, please see our Privacy Policy.

Sign here to confirm that all the details supplied are correct *