GIFT II FORM

GIFT II PROGRAM 2024
JOINT CONSENT OF YOUNG PERSON AND PARENT / GUARDIAN
DETAILS OF GIFT II PROGRAM
Name of Program GIFT II 2024

Time of Activity 7:00pm - 9:00pm

Sessions

1 Oct - Intro and Quiz
8 Oct - Fitness with CHris
15 Oct - Copper Art
22 Oct - Team Challenge
26 Oct - Scavenger Hunt and Gift II Mass

Organiser Brenda Webb
Mission Statement

We aim to bring children close to the Word of God through prayer, discussion and activities.
Details of Young Person Attending GIFT II 2024
Name of Young Person *
Name by which the Young Person is known *
Date of Birth*

DayMonthYear
Address*
Parent/Guardian Contact Details
Parent/Guardian Name*
Mobile Phone Number*
Relationship to Child*
Landline (If applicable)
Additional Responsible Adult

In case of an emergency
Name*
Mobile Phone Number*
Relationship to Child*
Landline (If applicable)
Other Relevant Information
Please provide details of any regular medication, medical condition (e.g. asthma, epilepsy, diabetes, allergies, dietary needs) or disability which may affect normal activity. If the Young Person has no medical conditions listed above, please enter 'Not Applicable'*
Please note: The organisers cannot administer any medication or intimate care, please discuss this with the organisers who will work with you to establish how your child can be accommodated, according to the relevant Policies and Procedures.
In The Event of An Emergency
In the event of illness or an accident, I give permission for medical treatment to be administered to my child, where considered necessary, by a suitably qualified medical practitioner and/or hospital.

I understand that every effort will be made to contact me as soon as possible. In an emergency, I can be contacted at the telephone numbers provided on this form.
Medical Emergency Consent*
Young Person's Consent For Use of Photographs / Video and Consent to Code of Behaviour
I (insert full name below ) would like to take part in the GIFT III Program.*

First NameLast Name
I understand that photographs may be taken during the group activities*

I GIVE permission for photographs taken during group activities to be used in any hard copy or online publications by the Parish or DioceseI DO NOT give permission for photographs taken during group activities to be used in any hard copy or online publications by the Parish or Diocese
I understand that videos (which may include webcam) may be taken during the group activities and that the Parish Webcam streams images 'Live' during all Masses*

I GIVE permission for videos (which may include webcam) taken during group activities to be used in any hard copy or online publications by the Parish or Diocese.I DO NOT give permission for videos (which may include webcam) taken during group activities to be used in any hard copy or online publications by the Parish or Diocese.
Code of Behaviour*

I understand that during group activities I will be appropriately supervised at all times and I agree to abide by the group’s code of behaviour.
Signature of Young Person*

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Parental / Guardian Consent For Use of Photographs / Video and Consent to Code of Behaviour
Refusal of consent for use of photographs/video

Please tick this box ONLY IF YOU DO NOT wish photographs/video (which may include webcam) to be taken of your child otherwise leave blank
Parent / Guardian Name (Please use block capitals)*
Relationship to Child*

ParentLegal GuardianOther
Date of Consent*
Details of 'Other' Ticked Above
Supervision and Code of Behaviour.

I understand that there will be suitable supervision and an agreed code of behaviour whilst my child is in the care of the organisers.
Signature of Guardian / Parent*
CODE OF CONDUCT

Applicable to Volunteers and Child members of the Children's Liturgy
Code of Conduct for Volunteers*
Code of Conduct for Children attending of Children’s Liturgy
DATA PROTECTION

In accordance with the Data Protection Act 2018
Diocese of Down and Connor Interim Child Protection Policy

These codes of conduct are based on the recommendation of the Diocese of Down and Connor interim child protection policy. If you wish to view this policy, or have any queries or concerns, please contact the Parish Office on 028 437 22401 or the Parish Safeguarding Committee on 07840028461.
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GIFT II PROGRAM 2024

JOINT CONSENT OF YOUNG PERSON AND PARENT / GUARDIAN

DETAILS OF GIFT II PROGRAM

Mission Statement

Details of Young Person Attending GIFT II 2024

Parent/Guardian Contact Details

Additional Responsible Adult

Other Relevant Information

In The Event of An Emergency

Young Person's Consent For Use of Photographs / Video and Consent to Code of Behaviour

Parental / Guardian Consent For Use of Photographs / Video and Consent to Code of Behaviour

CODE OF CONDUCT

DATA PROTECTION

Diocese of Down and Connor Interim Child Protection Policy