Primary Weekend Away Booking Form 2025

Young Person's School Year (at the time of the event)*
These events rely heavily on volunteers. Sometimes we need a little extra help. If you would be willing to help with any of the following please tick the boxes below. Please note, this doesn't commit you to anything but provides us with a list of people we can ask should the need arise.*

Fri set upSun set downKitchen help (full event)Kitchen help (day visitor)Pre event (eg resource preparation)I am unavailable at this time

Health Details

Please complete this form carefully. If it is not completed correctly it may result in your young person being given inappropriate medical treatment. Note: All information on this form will be held in confidence. Details will only be disclosed to relevant leaders e.g. small group leader and medical personnel as and when required.
1. Are there anymedical condition or recurring complaint the Weekend Away leader should beaware of, e.g. travel sickness, asthma, chest complaint, wheezing or hayfever, bed-wetting, diabetes, period pains, fits or faints, nervous disorders, any other illness or physical disability? (If yes, please give details)*
NB. None of the above will exclude your young person from the weekend. The information is needed to enable us to make appropriate arrangements for your young person.
2. Is he/she allergic to anything? (e.g. antibiotics, any particular food or medication etc) (If yes, please give details)*
3. Does he/she have any sensory disabilities/special needs statement/record of need statement?*
4. Does he/she require medication? (If yes, please give details below in the following format: He/She requires _____ for _____ to be taken at ____ or in the event of ____) *
Please note that all medication except inhalers for asthma and Epipens for acute allergic reactions should be handed in. Please send it with your young person, clearly labelled and in a zip locked bag. A record will be kept of all medication handed in and administered.
5a. Do you give permission for staff to give a painkiller if required?*

YesNo
5b. If yes, what would you normally give them from the list below (Tick all that apply)

ParacetamolIbuprofenCalpol or equivalent
6. Has he/she had an anti-tetanus injection within the past 5 years?*

YesNo
7. Does your young person have any allergens/dietary requirements that the catering team should be made aware of?*
Family Doctor's Details*

Street Address

Street Address Line 2

City

Postal / Zip Code
Family Doctor's Phone Number*

Area CodePhone Number
Emergency Contact Details*
Please include 2 emergency telephone numbers, if possible, which should be contactable at all times.
When final travel details are sent we will ask you to confirm that no details have changed from the above information.
Declaration
- In the event of a medical emergency, I hereby authorise the weekend leader / volunteers to act on my behalf and to sign on my behalf any required declaration.
- I understand that in the event of an emergency the contacts named above will be advised.
- I understand all activities are covered by St Mungo’s Public Liability Insurance but that there is no insurance for personal accident.
- I understand that the weekend leader reserves the right to contact the parent/guardian to take their son/daughter home in the event of a breach of the weekend rules as stated in the final arrangements letter, if necessary.
- To the best of my knowledge, the information given above is accurate.
Signature*

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Photo Permission Form
To comply with the Data Protection Act 1998 we need your permission before we use your image or any images of your child/children (under 18). We are aware that a number of you will have already completed a similar form, but to ensure everyone on the weekend is covered by a photo consent form, we're asking for fresh permission from everyone.

Please answer the questions below

FYI, these images are typically used in the following ways:

Online websites and galleries which are administrated by St Mungo’s Church, including the St Mungo’s Church and Youth websites and dedicated
Facebook pages.
Slideshows and video presentations made at St Mungo’s Church events.
Printed publications relating to St Mungo’s Church events.

All images are stored securely (e.g. on a secure server or password protected storage device). See below form for more detailed information.

Conditions of use

This consent is valid only for the length of time you are part of St Mungo’s. You can opt out at any time by contacting the St Mungo’s Administrator.
When a particular media is used to support a specific group and is closed to outside individuals (e.g. the St Mungo’s Youth Instagram), we may name individuals in images. In any other circumstances we will not publish personal details alongside your image.
We will only use images of people who are appropriately dressed / presenting themselves in an appropriate way.
Name of child*

First NameLast Name
Email (parent/guardian)*
example@example.com
May we use images taken on our St.Mungo's administrated online sites (e.g. website, dedicated Facebook pages)?*

YesNo
May we use images taken in presentations at our Church events?*

YesNo
May we use images taken in assisting a staff member to present St. Mungo's at another Church or Christian event?*

YesNo
May we use images taken in printed publications relating to our Church events?*

YesNo
I have read and understood the conditions of use (see paragraph above):
Signature*

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OUR POLICY FOR THE USE OF PHOTOGRAPHIC AND VIDEO IMAGES

St Mungo's takes very seriously its duties to respect the confidentiality and privacy of all people we engage with. All our staff and volunteers are asked to treat as confidential any information or personal data that they come into contact with relating to individuals in our church. No information will be passed to a third party without express permission, except in cases of child protection concerns.

The following accompanies the consent form for use of images; it outlines St Mungo’s working practices and the legal position regarding the use of images:

• The right to privacy
• The use of your image
• The storage of your image

THE RIGHT TO PRIVACY

Under the Data Protection Act of 1998 the taking of an image of any person’s face out with a crowd shot needs the individual’s permission

By law, verbal permission is often deemed acceptable; however St Mungo’s Church would prefer to have all permission in writing for each and any individual who is photographed or videoed.

This applies to anyone attending a St Mungo’s organised event or programme. For individuals under the age of 18, it is very important that parents, guardians, and carers are aware of the boundaries of this act.

The law only applies to images where the person concerned is the main focus or subject of the picture. Otherwise, St Mungo’s does not require the person’s permission. Any identifiable individual who is concerned about their inclusion in a crowd/group shot should contact Wendy Brown, the St Mungo’s Administrator immediately (wendy.brown@stmungos.org).

THE USE OF YOUR IMAGE

Images are used for information, reporting back, celebrating events, and sharing enjoyment within St Mungo’s Church, promoting future events and for the interest of others in the wider community.

Who may take your image?

St Mungo’s church staff and volunteer leaders and designated photographers may take images. Any kind of camera or recording device may be used including personal mobile phones.

Images taken will be verified against a register of consent before usage where necessary. If consent cannot be verified then an individual’s image will not be used and removed.

Please note that St Mungo’s cannot take responsibility for images that other Church event attendees may take.

What do we use images for?

The images are for use on online websites and galleries which are administrated by St Mungo’s Church. This includes the St Mungo’s Church and Youth websites and dedicated social media pages. The images may also be used in presentations and printed publications relating to St Mungo’s Church events.

Please be aware: St Mungo’s operates a policy in accordance with the legal age stipulated in any forms of communication used. For example, in accordance with Facebook’s legal age limit, young people under 13 will not be added to Facebook pages.

When a particular media is used to support a specific group and is closed to outside individuals (e.g. the St Mungo’s Youth Facebook group), we may name individuals in images. In any other circumstances St Mungo’s will not publish personal details of individuals without express permission for the specific image.

If at any time you wish to reconsider any consent given, or you have any concerns, please contact Wendy Brown on the email address above.

STORING IMAGES

Images are stored in a secure way.

In order for St Mungo’s to manage images, images and names are stored securely (e.g. on a secure server or password protected storage device). The names enable the swift location, retrieval and removal of images at an individual’s request.

Payment Information

We can confirm details of pricing is as follows:

£145 total cost if booked by 31 March.

£150 total cost from 1 April.

Bookings close 31 May.

Tickets can be secured with a £25 deposit per person and full payment due by 31st July. You will receive a Churchsuite payment event for the remainder.

Please note we do not want cost to be a barrier to any of your children being able to attend so please do get in touch with Caitlin (caitlin.boddy@stmungos.org) or Katherine (katherine.burnett@stmungos.org) if this is an issue. Payment installment plans are also available if required.

My Products*

Deposit Primary Camp - LM 2025 £25 payment to secure your booking. Full payment will be due by 31st July.

£25.00 Quantity

Total

£0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

I can confirm I have read the above and commit to paying the above sum for my child to attend the weekend away*

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Health Details

Photo Permission Form

Payment Information