Youth Activities Consent and Registration (Hope Church Kensington)

Please complete this form for your child(ren) participating in activities and events run for young people with Hope Church Kensington.

Your name *

Last name

Email address *

Household members

Please complete the information requested below for all young people participating in youth activities with Hope Church. You don't need to fill out the 'Add Adult' section as we will have already collected this information from you.
For each young person, please click 'Add child' to fill in their details. In the medical notes section, please include any dietary requirements as well - anything it would be helpful for the Hope Church team to be aware of, or if there is nothing we need to be aware of please write 'none'.

Phone number *

Phone type

Parent/Carer’s Address: *

Please include the postcode.

Name of your child(ren)'s GP, GP Surgery, address and phone number: *

In the event that you are unavailable or uncontactable, please provide the details of an emergency contact other than yourself:

Emergency Contact Name: *

Emergency Contact Phone Number: *

Relationship to your child(ren): *

I give consent for my child to be released to this person in the event of an emergency or illness if I cannot be contacted or am unavailable. *

Consent to participate in Hope Church youth activities

I give my permission for my child(ren), named on this form, to participate in all youth activities run by Hope Church *

Yes

Transport for young people with Hope Church leaders *

Please select your response to give permission for the named child(ren) on this form to travel by public transport or in a car with one of the Hope Church team where required. More than one adult will be present for this, unless expressly communicated and permission sought otherwise, and DBS/insurance checks will have been completed on those involved.

Emergency and Medical Consent: *

I agree for my child to be given first aid by a trained member of the Hope Church team if necessary. This includes applying plasters and the administration of any medication specified above.

In the event of an emergency, where I cannot be contacted, I agree for my child to receive urgent dental, medical, or surgical treatment, including anaesthetics, as may be considered necessary by the medical authorities present.

I agree to my child’s information being shared with the NHS and/or other relevant professionals in the case of an emergency.

Personal Information Consent

Photography and Video Consent *

I agree to photographs and short videos of activities including my child to be taken for use within the church community and for occasional publication including print, social media an/or website in accordance with the Cornerstone Collective Privacy Notice.

Yes

Additional photography/video consent: *

A leader can’t always prevent young people from taking photos/videos. If there’s a safeguarding issue with capturing/broadcasting of photos/videos of my child then I’ll alert the Hope Church leaders, allowing them to respond appropriately.

I agree for the Cornerstone Collective to use our data and contact me about any news, events and activities *

Yes

If you have any further information you would like to provide, or you have any queries, please get in touch at josh@hopechurchkensington.org.

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Cornerstone Collective of Churches
info@cornerstone-collective.org