A DAY WITH MARY Youth Day Registration Form

WHAT, WHEN, WHERE, WHO?

WHAT: A day of faith, fun, games and preparation as we ask the question 'Who is Mary and why should I care?' This will give our kids the opportunity to learn about the absoulte gift of Mary as our Mother through games, talks, activities, and Holy Mass!

WHEN: The event takes place Saturday the 11th of May. Registartion starts at 11:00am and the day concludes by 15:00

WHERE: The youth day will be hosted in the Gillis Centre in Edinburgh.

WHO: This event is open to all primary 4 - 7 children.

WHAT ELSE: We will keep your kids fuelled with sweets and snacks, but please send them off with a packed lunch. Please God we will have clear skies, so suitable warm outdoor clothing should also be brought. If your child requires any medication, please let us know in the consent form, and ensure that medicines are packed and clearly labelled.

This is going to be a great day and we can't wait to see your kids there. Spaces are limited so send your forms back ASAP to secure your place!

God Bless you!

Fr Martin & Fr Robert

REGISTER NOW.

Child Name*

First NameLast Name

Birth Date*

DayMonthYear

Gender*

Address*

House Number / Name

Street Address Line

CityCounty

Postal Code

Responsible Adult *

First NameLast NameRelationship to Child

Responsible Adult E-mail*

example@example.com

Mobile Number

Work Number

Area CodePhone Number

Phone Number

Area CodePhone Number

Additional Responsible Adult *

First NameLast NameRelationship to Child

Additional Responsible Adult E-mail*

example@example.com

Mobile Number

Phone Number

Area CodePhone Number

Work Number

Area CodePhone Number

CHILD'S MEDICAL INFORMATION

Please provide details of any special dietary requirements or allergies.

Please provide details of any medical conditions (e.g. asthma, epilepsy, diabetes, allergies) or disability that may affect participation in the planned activities.

Please provide details of medical treatment including medication, e.g. inhalers, anti-epileptics, pain/flu relief, insulin, related to the above conditions.

Please outline any fears, phobias or anxieties which may be related to activities, to enable helpers to assist the child should any difficulties arise.

Date on which your child received a tetanus injection:

Is your child allergic to any medication, e.g. penicillin?*

YesNo

If so, please provide details.

Name of Family Doctor *

First NameLast Name

Phone Number*

Area CodePhone Number

Surgery Address*

Name of Surgery

Street Address Line

CityCounty

Postal Code

PARENTAL CONSENT

Declaration:

I give permission for my child to take part in the activities of the Parish Youth Group.

I understand that my child's welfare and safety, and the health and safety of others, will be paramount at all times. He/she will agree to respond to the authority of the Group Leaders towards the promotion and preservation of the health and safety of all those young people attending the event.

I understand that during the period my child will be in the charge and under the instruction of the Group Leaders and that while all reasonable care will be taken by those in charge of my child, they cannot necessarily be held responsible for any injury, loss or damage of personal effects suffered during or after the event.

In the event of an illness or accident every effort will be made by the event leader or their assistants to contact me. If, for whatever reason, this is not possible, I agree to my child receiving medication as instructed and any emergency dental, medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities present.

Parental Consent: Do you agree to the above Declaration concerning your child?*

YesNo

MEDIA CONSENT

I give permission for any picture of my child that has appeared in local Press to be used also on the Archdiocesan/ Parish website/social media, to be displayed in the Church and/or included in an Archdiocesan/Parish publication.

YesNo

I give permission for a designated person (appointed by the Parish Priest) to take photographs and/or video of my child at parish events and for those images to be used on the Archdiocesan/Parish website/Facebook page, to be displayed in Church and/or included in an Archdiocesan Parish publication. (N.B. No child’s name or identifying information will be published alongside any image.)

YesNo

I reserve the right to request that any such image is removed and I shall make such a request in writing.

YesNo

Signature

Date

Data Protection:

The Archdiocese of St Andrews & Edinburgh complies with Data protection, DGPR, and Marketing legislation and the code of Fundraising Practice. Your date will be stored securely and only be used for the purposes for which is was collected. We will not transfer your data to third parties to use for their own marketing or fundraising purposes. You can read out full privacy notice on: https://archedinburgh.org/privacy-policy/. The Archdiocese of St Andrews & Edinburgh is a Charity registered in Scotland, charity number SC008540.

A DAY WITH MARY: Youth Day Registration & Consent Form