Parental Consent Form

Parental Consent Form

For ACT NOW: Creative Youth CIC
Name of Child

First NameLast Name
Date of Birth

MonthDayYear
Date
School Name or Home Schooled
Name of Parent/Guardian

First NameLast Name
Relationship to participant
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any Medical or Special Educational Needs our staff should be aware of to support the participant?
How will the participant arrive and leave
Emergency Contact details

These are the details of the person most likely to be available during session time and able to come earlier than the end of the session if a participant is ill or injured.
Please choose
If other please give details of name, contact phone number, and relationship to participant below.
Photography and Film Consent of participant.

Sometimes we take photographs or video film for publicity and project purposes. These images may appear in printed publications, news media, funding evidence, or filming projects. We require your permission to do this. Our Safeguarding policy is to never use images on social media, and request that parents who take their own photographers during performances (please NO flash) keep them for their own memories and never to put these images online social media.
Please tick all option you are willing to consent to.

Participant can be in images, filmed or photographicThe image may be used in support of funding evidenceThe image may be used in publicity for the group activitesThe image may be in news media/local pressI/We agree that ACT NOW: Creative Youth CIC may use the images as set out above
Terms and Conditions - Please carefully read

All information will be stored in line with GDPR guidelines. All Consent Forms are kept for the duration of the participant’s attendance plus five calendar years after leaving.
1. This form is valid for the duration of the participant’s attendance plus five years unless otherwise stipulated by either party.

2. The consent will automatically expire after this time. We will not re-use any images after this time.

3. We will not include details or full names (which means first name and surname) of any child or adult in an image on our website, or in printed publications.

4. We will not include personal e-mail or postal addresses, or telephone or fax numbers.

5. If we use images of individual pupils, we will not use the name of that child in the accompanying text or photo caption without further consent.

6. We may use group images with very general labels, such as “Scene from upcoming show” or “ACT OUT/ACT UP youth drama group”.

7. We will only use images of pupils who are suitably dressed, to reduce the risk of such images being used inappropriately.

8. We cannot film or take photographs of any child that is at risk or under a supervision order.
Tick and sign this to complete parental consent form.

I give permission for him/her to take part in ACT NOW: Creative Youth CIC workshops and performances.I am the parent / legal guardian of the child named above and I have the right to make decisions for them.I have disclosed all physical, mobility, cognitive or health issues which may affect the participant during the activityI understand that the participant is not in any way required to participate in the programme and related activities but is doing so willing
Date of signature

MonthDayYear
Date
Signature

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Parental Consent Form

Emergency Contact details

Photography and Film Consent of participant.

Terms and Conditions - Please carefully read