• Gathered Youth Extra Activity Form

  • This form is for extra activities ran by Gathered - A Partnership Ministry.

    The Partnership consists of The Grouped Parishes of Ballyrashane & Kildollagh, The Grouped Parishes of Ballintoy & Dunseverick with Rathlin Island, St Patrick's and St Andrew's Coleraine and Dunluce Parish, Bushmills.

    Please complete this form completely and correctly.

  • Young Person's Details

  • Young Person's Date of Birth*
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  • Child's Gender*
  • What Parish is your young person connected to?*
  • Date of Activity*
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  • Contact Details

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  • Date Form is Completed*
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  • 2nd Person with Responsibility for Your Young Person

    Incase you cannot be contacted
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  • Medical Details

  • I give permission for first aid to be administered to my son/daughter*
  • In the case of an emergency, staff and volunteers will do everything reasonable to contact the parent/guardians named in this form. In circumstances where medical treatment is required immediately and where it is not possible to contact those named on this form, do you authorise the leader-in-charge of the group to refer your son/daughter to a medical practitioner or emergency services on your behalf and to sign on your behalf any written consent required in the event of a life-threatening injury/condition?*
  • Date that this form is completed*
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  • Consent for Photos and Recorded Images

    In accordance with our Safeguarding Trust child protection policy, parent/guardians are asked to give consent for the taking of photographs and recorded images on the understanding that images will only be used for parish communications including the Parish magazine and Facebook page, Diocesan and Church of Ireland publications both paper and digital and that consent can be withdrawn at any time by contacting your parish office.
  • Do you consent to the photographing or recording of your young person named above?*
  • Do you consent to the photographing or recording of yourself?*

  • Code of Behaviour

    The code of behaviour for the children and youth in parish activities is to ensure that children and young people are treated fairly and are aware of their basic rights and responsibilities here. It aims to help foster co-operation, respect and encouragement and prevent unacceptable behaviour

  • Children, Young People and Leaders are expected to:

    • Be friendly and supportive to each other
    • Respect the views, feelings and differences of others
    • Participate in the group activities
    • Respect the property and belongings of others
    • Not pressurise anyone to undertake something they are uncomfortable with
    • Not use any language or behaviour that could upset or disrespect others
    • Refrain from bringing any banned substances to the group such as high-energy drinks, nut-based foods or alcohol
    • Refrain from taking photos or sharing information about others online without their expressed permission and the permission of leaders
    • Respect the wishes of leaders in directing the activities of the group
    • Report risky situations, incidents and inappropriate behaviour to the leadership of the group
    • Be willing to apologise to each other when conflict occurs

  • If a child breaks the code they will be:

    1. Reminded of the code and asked to comply in future
    2. On consistent non-compliance will be given a formal warning by the leader
    3. On continued non-compliance will be given a sanction such as loss of privileges or suspension. This will be recorded and parents informed.
    4. Continued non-compliance may result in a longer or permanent suspension from the group. This will also be recorded and parents informed.

  • GDPR

    We are committed to protecting your personal information. The parish will hold and process your personal data for the purpose of contacting you. If you have any questions about how we process your personal data contact a member of the select vestry through your Parish Office.

  • Policy Information

    The church has several policies that relate to working with children and young people, including Safeguarding Trust child protection policy, anti-bullying policy, communications policy, partnership with parents policy, complains procedure and GDPR. If you would like a copy of any of these please see a member of the Parish Panel or contact the parish Office.

  • I confirm that all information inputted into this form is correct.

    Please note that only forms completed and signed by a parent or Guardian of the young person who is the subject of this permission form can be accepted.

  • Date that this form is completed*
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  • Should be Empty: