Gaming Nights Media Annual Form 2026

General Information and Consent Form Respawn Gaming Nights.

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.
🎮✨ Respawn Gaming Nights are here! ✨🎮
Each night will also include a short faith chat, inspired by the world of gaming—designed to get young people thinking, questioning, and connecting.
We’ll have Xbox, Nintendo Switch, and even some classic games – fun for all skill levels!

Snacks and Drinks will be served each week – because gaming is better with snacks!

Please let us know about any dietary requirements or allergies so we can cater for everyone.

📋 Important Info:
Open to Primary 7 & S1–S6.
All young people attending must have a form completed by a parent/carer.
We also have a policy to verify contact information – so don’t be alarmed if one of our team phone and checks in. It’s all part of keeping everyone safe.

📍 Lenzie Church of Scotland Dean House 65 Kirkintilloch Road Lenzie, G66 4LD
Come play. Come chat. Come belong.

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

Email: youthworker@lupc.org (contact info may change in due course due to transition to new church Lenzie Church of Scotland from formally known as Lenzie Union)

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

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
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)

Area CodePhone Number
Evening
Name of additional person responsible for child or young person:

Contact details of additional person responsible:
Telephone No. (Day)

Area CodePhone Number
Evening
Name of GP
GP's Telephone No

Area CodePhone Number
Date of last tetanus

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
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
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
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.
For last minute update or cancelling of events we will let you know by phone or email. If you would like to provide email address to hear about future events and stay up to date please provide below.
example@example.com
Media Consent

Lenzie Church of Scotland are 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. We may take photos or short videos during Respawn Gaming Nights to share highlights with our church & Third party organisation involved in the organising of the gaming project or on social media. Third party organisations involved in this project are Alpha Scotland, Scripture Union Scotland (SU Scotland), the Church of Scotland nationally, and Glasgow Presbytery.
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)
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
For the following purposes: (please tick all that apply)
Using Internet Technology. I hereby authorise Respawn Gaming Night can communicate using social media applications with the below named young person/vulnerable adult (please tick relevant box)
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
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Should be Empty:

Media Consent

Consent