Children's Groups
Consent Form
To be completed by a parent or legal guardian of under 18s. Print this page, fill it in and hand it to a group leader.
To be completed by a parent or legal guardian of under 18s. Print this page, fill it in and hand it to a group leader.
Use the button below. Only the form below will print, not the rest of the page.
Complete Parts B and C. These are for a parent or legal guardian of under 18s.
Give the completed form to one of the group leaders.
We look after your information as described in our Privacy Policy.
Name of group
Christ Church Network Children's groups
Brief description of activities
Bible story, discussion, games, activities & refreshments
(To be completed by a Parent or Legal Guardian of under 18's)
Child's full name
Date of birth (dd/mm/yy)
Normal address
School attended
Does your child take any regular medication or have a medical condition (e.g. Asthma, epilepsy, diabetes, any allergies, dietary needs etc) or disability which may affect normal activity?
Does your child have any educational or behavioural needs that we should be aware of?
In an emergency or if I am not contactable, I am willing for my child to receive necessary hospital treatment including an anaesthetic.
My child can be given penicillin.
I give permission for my child to take part in the normal activities of the group. I understand that separate permission will be sought for certain activities away from the normal meeting place. I recognise that while involved he/she will be under the control and care of the group leaders approved by the church eldership and that while those in charge will take all reasonable care, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during, or as a result of the activity.
Tick here to give your consent
Parent/Guardian name
Home tel
Mobile
Signature
Date
(To be completed by a Parent or Legal Guardian of under 18's)
I give permission for photographs/video of my child to be taken as part of the group activities and used for legitimate purposes relating to the group or the Christ Church Network, including publicity, displays, website and social media. Under 18's will not be identified by name on any photographs without expressed permission.
I give permission for my child to get to and from the group without parental supervision.
It is often useful if the group leaders can contact your child directly by mobile phone or email with messages relating to the group. If your child has a phone and/or email and you agree to this please give your child's phone number and/or email address below.
Child's Mobile
Child's Email