Consent Form

Your privacy matters to us. Well will not give, sell, trade or use you information in any manner other than to contact you.

Please click here to see the Band’s Privacy Notice.

Consent Type*

Specific Event?

Event

Relevant Period

1 October to 30 September

Or Date?

Date

Child's Name*

First Name(s)Last Name

Date of Birth*

dd/mm/yyyy

Parent/Guardian*

First Name(s)Last Name

E-mail Address*

Confirmation EmailEnter and confirm your email address

Address*

House Name/No. & Street Address

Street Address Line 2 (if required)

Village/Town/CityCounty (optional)

Postcode

Emergency Contact Number*

No spaces

During the course of the year the Band will be performing at various Galas, Concerts, Competitions and the like as detailed on the Engagement Sheet. Updated versions of this engagement sheet are issued at regular intervals during the year and current information can also be accessed on the Calendar page of the Band's website. Some/most of these engagements will involve your child being supervised by adult members of the Band for prolonged periods during the day. To cover any eventualities that may arise parental consent is required and the following information and permissions should be provided. The Band’s Protection Co-ordinator, should be contacted if, at any time during the year, the information provided requires to be updated.

In addition, due to the nature of the Band as an attraction, spectators at the events may take photographs and video recordings. In addition the Band may wish to have photographs or video/DVD recordings taken to promote the Pipe Band in the future.

No official photographs or video/DVD recordings may be taken without parental consent.

Medical Information

1. Does the participant have any specific medical condition requiring medical treatment and/or medication?*

Yes/No

If Yes give details

Details

2. Allergies?*

Yes/No

If Yes give details

Details

3. Any contact with contagious or infectious diseases within the last four weeks?*

Yes/No

If Yes give details

Details

Please notify the Band’s Protection Co-ordinator, should the participant come into contact with contagious or infectious diseases during the course of the year.

Please provide details of any special dietary requirements and the type of pain/flu medication that may be given:

Dietary/medication restrictions

Please enter details

I confirm that I have received the details of the above activities and consent to my child taking part in the visits and activities indicated. I acknowledge that the North Berwick Pipe Band (the Band) will be liable in the event of an accident only if they have failed to take reasonable steps in their duty of care for my child during the event. I understand that those in charge have a common law duty to act in the capacity of a reasonably prudent parent.

I have read the Code of Conduct and agree that my child should abide by this whilst in the care of the Band and I understand that a serious or continued breach of this code may result in my child being sent or brought home early at my expense.

If relevant to this consent I agree to allow my child(ren) or any vulnerable adult for whom I have responsibility to be photographed.

I,

Enter name

being parent/guardian of the above named child give permission for the Office Bearers of the Band in charge of the activity to give the immediately necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son/daughter’s interest, in the doctor’s medical opinion, for any delay to be incurred by seeking my personal consent.

Date of 'Signature'*

Date

By clicking the 'Submit' buttom you confirm your agreement with the details included in this form.

Enter the message as it's shown*

CONSENT FORM