Newhaven Church Children & Young Person Registration Form (SG16 & SG19)

In order to ensure your child’s safety, we would be grateful if you would complete and return this form. Please let us know if any of these details change. A copy will be retained by the Children's & Youth Worker and information shared with Children's & Youth ministry team members as appropriate to the activity. This form covers consent for Sunday Groups, Pizza & Pudding, & Messy Church. Additional consent is required for trips and special activities.

Congregation:*

Name of child or young person:*

Date of birth of child or young person:*

Date

Address of child or young person:*

Name of parent or guardian responsible for child or young person:*

Email*

Phone number*

I am happy to receives emails from Newhaven Church Children's & Youth ministry relevant to my child or young person. *

Name of additional person responsible for child or young person:*

Contact details of additional person responsible:

Email

Phone number*

Name of GP:

GP's Telephone No:

Date of last tetanus:

Date

Details of any regular medication, medical condition (e.g. asthma, epilepsy, diabetes, allergies, dietary needs) that it would be beneficial for the team to know about?*

Does your child have any additional support needs or learning differences that it would be important to be aware of to help your child enjoy and get the most out of groups (sensory processing, anxiety, dyslexia, etc) *

 I understand that while involved in the activities of this group, he/she will be under the control and care of the group leader and/or other adults approved by the church leadership and that, while the staff in charge of the group will take reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during, or as a result of the activity.*

Yes, I understandIn an emergency and/or I cannot be contacted, I am willing for my child to receive necessary hospital or dental treatment including an anaesthetic.

I allow Newhaven Church to use my child or young person's photo, video, voice recording, artwork, or written media (eg poem), un-named, in the following.

Printed & Electronic Publication (newsletters)On Display at the Church/As part of church activitiesOn Social Media and the Church faecbook pageIn advertising church activites

My child is 11 or older and I wish for them to be sent information relevant to the groups they are a part of to their own email address and therefore I provide it below.

My child is 11 or older and I allow them to participate in online group conversations and activities currently taking place instead of regularly scheduled face to face youth activities due to the Covid-19 situation. These will take place with the same safeguarding ratios as face to face groups.

If you have any queries, please contact the Church of Scotland Law Department.

Date:

Date

The purpose of the UK Data Protection Act 2018 is to ensure that any personal data 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/

This congregation is committed to protecting privacy and safeguarding personal data. We shall use the information you have provided us with for safeguarding purposes and related matters and will only keep the data for as long as required for that purpose. The full Privacy Notice for our congregation is available on our website. Please ask for details from your Safeguarding Coordinator.

Should you have any questions concerning the use of the information you provide please contact the Safeguarding Coordinator.

In lieu of a signature, I confirm that the above information is true and valid and has been filled in by the person with care responsibility for the child or young person named. I will be in contact with the Children's and Youth Worker to update relevant information as needed.

Forms SG 16&19

General Information and Consent Form

Data Consent