Youth Cafe Consent Media Annual Form 2025-2026

General Information and Consent Form For Youth Cafe 2025-2026 Session

In order to ensure your child's safety, we would be grateful if you would complete and return this form. Please let us know if any of these details change. A copy will be retained confidentially by the group leader.
Dear Parents/Carers,

We are delighted that your young person has joined our Youth Café! This sheet provides some background information about the group.

Youth Café is facilitated by Kim Halliday-Robertson, Children and Youth Worker at Lenzie Union Parish Church, alongside a team of dedicated volunteers. All our leaders live, work, or study locally and share a passion for creating a welcoming, exciting, and enjoyable experience for young people.

All leaders aged 16+ have completed the relevant PVG safeguarding checks, and we follow the Church of Scotland’s Safeguarding and Safe Recruitment guidelines. Older teenagers within the group are encouraged to support younger members, with appropriate training and supervision provided.

Who Can Join?

Youth Café is open to all young people from S1 to S6. We aim to be as inclusive as possible. If your child has additional needs, please feel free to contact us to discuss how best we can support them.

While our group has a Christian emphasis, there is no requirement for members or their families to attend church.

When and Where?

We meet on Thursdays during term time, from 3:45–5:00pm at Lenzie Union Parish Church. There is no fee to join—our running costs are covered by the church or external funding.

Expectations

We ask all young people to cooperate with leaders and follow our simple rules, which are based on respect—for one another, for property, and for the spaces we use. Attendance signifies a willingness to abide by these guidelines.

What’s the Programme?

Each week, we offer a variety of supervised activities including games, sports, crafts, and more. We also spend a short time exploring life issues from a Christian perspective, supporting young people’s spiritual well-being. Trips, and special events may be arranged throughout the year.

Safety Matters

The safety and well-being of our young people is our highest priority. We follow comprehensive guidelines from the Church of Scotland to ensure safe practice.

Our responsibility begins when your child enters the building at 3:45pm. We provide appropriate supervision during all activities. If a young person chooses to leave the premises during a session, they do so at their own risk.

We operate a sign-in and sign-out system, including emergency contact details. If your child needs to arrive late or leave early due to other commitments, please ensure they follow this process. Once a young person signs out, responsibility transfers back to their parent/carer.

Communication

When your child joins Youth Café, you’ll be asked to complete a Youth Cafe Consent Media Form with your contact details. This allows us to communicate about group activities and reach you in case of emergency.

You can also opt in to receive updates about other children, youth, and family activities at Lenzie Union Parish Church via email or WhatsApp.

We keep in touch with young people through our monitored social media accounts:

Instagram: @LenzieUnionYouth
Facebook: @LenzieUnion
Most communication with parents/carers is via text or email. For trips and offsite events, we’ll provide advance notice and ensure contact arrangements are in place.

Joining Youth Café

To join, please complete and return the Youth Cafe Consent Media Form when your child first attends. If needed, it can be brought back at their next visit. Kim Halliday-Robertson will be in touch via phone, email, or text to introduce herself and share reminders. We also verify emergency contact details as part of our safeguarding procedures.

Contact details – Main Leaders
Name: Kim Halliday – Children & Youth Worker at Lenzie Union

Email: youthworker@lupc.org

Phone: 07482 678955
Congregation
Church group
Name of child or young person
Date of birth of child or young person

MonthDayYear
Date
Address of child or young person
Name of parent or guardian responsible for child or young person
Contact details of responsible person:
Telephone No. (Day)
Evening
Name of additional person responsible for child or young person:

Contact details of additional person responsible:
Telephone No. (Day)
Evening
Name of GP
GP's Telephone No
Date of last tetanus

DayMonthYear
Date
Details of any regular medication medical condition eg asthma epilepsy diabetes allergies dietary needs or disability which may affect normal activity
I give permission for my child as named above to participate in the normal activities of this group.

I understand that separate permission will be sought for certain activities and outings lasting longer than the normal meeting time of the group.

I understand that while involved in the activities of this group, he/she will be under the control and care of the group leader and/or other adults approved by the church leadership and that, while the staff in charge of the group will take reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during, or as a result of the activity. In an emergency and/or I cannot be contacted, I am willing for my child to receive necessary hospital or dental treatment including an anaesthetic.
If you have any queries please contact the Church of Scotland Law Department
Signature of parent or guardian responsible for child or young person

Clear
Date

DayMonthYear
Date
The purpose of the UK Data Protection Act 2018 is to ensure that any personal data an organisation holds about an individual is stored and used in an appropriate way. This congregation, through presbytery, is registered with the Information Commissioner's Office and strives to comply fully with data protection law. The Information Commissioner's website provides in-depth information regarding the requirements of the Data Protection Act: https://www.ico.org.uk/ This congregation is committed to protecting privacy and safeguarding personal data. We shall use the information you have provided us with for safeguarding purposes and related matters and will only keep the data for as long as required for that purpose. The full Privacy Notice for our congregation is available on our website. Please ask for details from your Safeguarding Coordinator. Should you have any questions concerning the use of the information you provide please contact the Safeguarding Coordinator.
Communication about Children, Youth and Family Events

We would love to keep in contact with you regarding Youth Cafe and any other event we are running either by WhatsApp or Email.
Would you like to be added to our Youth Cafe WhatsApp Group for updates on the groups and other events that may be of relevant to you and your family. (you can withdraw from group at anytime)

YesNo
Please supply the numbers or number you like to be added to WhatsApp group.
If you like to join or remain on our mailing list by email please provide your email address below.
example@example.com
Media Consent

Lenzie Union are committed to ensuring church activities follow good practice. This includes collecting information and adherence to safe storage guidelines as outlined in the Good Practice Guidelines for use of photography/video within the Church of Scotland.
Consent

I hereby authorise the Congregation of Lenzie Union Parish Church to publish the following media/information about the below named young person/vulnerable adult: (please tick all that apply)
(please tick all that apply)

PhotographsVideosVoice RecordingsArtworkWritten Material
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
For the following purposes: (please tick all that apply)

For inclusion in the Congregation's publications, whether in print or electronic formatWithin the church premises eg notice boardsFor use on the Congregations website, Facebook page and twitter page, instagramFor inclusion in any of the Congregation's publicity, presentations, banners or marketing material.
Using Internet Technology. I hereby authorise church group Youth Cafe can communicate using social media applications with the below named young person/vulnerable adult (please tick relevant box)

YesNo
Name

First NameLast Name
Agreement

I can withdraw consent at any time by contacting the Congregation’s Safeguarding Coordinator.

I understand any media or information as agreed above and which is published prior to withdrawal of my consent may not be able to be withdrawn.

I understand any media or information as agreed above will not be used in any new material following withdrawal of my consent.

Giving or withdrawing consent will not affect any services that I or my child/charge receive or any future dealings I or my child/charge may have with the Congregation.

Consent forms will be completed annually.
Name

First NameLast Name
Type a question
Signature

Clear
Date

DayMonthYear
Date
Should be Empty:

Communication about Children, Youth and Family Events

Media Consent

Consent