Greenbank Parish Church, Edinburgh
Young Person Consent Form

This form must be completed by someone with parental responsibility for a Young Person who wishes to assist in the Youth Programme of Edinburgh Greenbank Parish Church of Scotland.

Edinburgh Greenbank Parish Church of Scotland is committed to protecting privacy and safeguarding personal data.  We shall use the information you provide to us solely for the administration of Greenbank’s Youth Programme and related matters, and will only keep the data for as long as required for that purpose.  If you have any queries, please contact the Church of Scotland Law Department.

DATA PROTECTION ACT

The purpose of the UK Data Protection Act 2018 is to ensure that any personal data which an organisation holds about an individual is stored and used in an appropriate way. This congregation, through presbytery, is registered with the Information Commissioner’s Office and strives to comply fully with data protection law.

The Information Commissioner’s website provides in-depth information regarding the requirements of the Data Protection Act: https://www.ico.org.uk/

Please read the following statements, indicate whether you agree with them, and then complete the form below.

1. I have parental responsibility for the Young Person named below.

2. I am willing to allow the Young Person named below to take part in and assist in Greenbank Young Church activities including Greenbank Holiday Club.

3. I understand that while involved in Greenbank Young Church activities, he/she will be under the control and care of the activity leader and/or other adults approved by the church leadership and that, while the staff in charge will take reasonable care of the young people assisting, they cannot necessarily be held responsible for any loss, damage or injury suffered by the Young Person during, or as a result of, Young Church activities.

Do you agree with the above three statements?:*	Yes No
Your Name:*
Your Address:*
Your Telephone Number:*
Your Mobile Number:*
Your Email Address:*
Emergency Contact Name:*
Emergency Contact Telephone Number:*
Young Person's Name:*
Young Person's Date of Birth:*
Young Person's Gender (optional):	Male Female
Young Person's Secondary School Year from this August:*
With respect to the Young Person, details of any regular medications, medical conditions (e.g. asthma, epilepsy, diabetes, allergies, dietary needs) or disabilities which may affect normal activity (state 'NONE' if none):*
Young Person's GP's Name, Address and Telephone Number:*
I confirm that the above details are complete and correct to the best of my knowledge:*	Yes No
In the event of illness or accident I give permission for appropriate first aid to be given by the nominated first-aider. In an emergency and if I cannot be contacted I am willing for hospital treatment including anaesthics to be given:*	Yes No
I give permission for my details and those of my Young Person to be entered into the church database:*	Yes No
I give permission for my Young Person's photographs to be used in Greenbank online and printed publications:*	Yes No
I give permission for my Young Person's photographs to be used on Greenbank's social media pages:*	Yes No
I give permission for my Young Person's photographs to be used within Greenbank's church premises, e.g. on monitors/ screens, notice boards:*	Yes No
I give permission for my Young Person to be seen and heard in live streaming of services and on recordings of these services (Live streaming and recordings will be publically available):*	Yes No
I give permission for Greenbank youth leaders to communicate using social media with my Young Person:*	Yes No
Are you happy to be included in a WhatsApp group for parents/guardians?:*	Yes No
If you answered 'Yes' to the previous question, are you happy for photos of your Young Person to be shared on a WhatsApp group for parents/guardians?:	Yes No
Please enter the verification number on the right:*
* Required Fields