Theology Ireland Youth Consent Form
Thank you for taking 5 minutes to fill out this form. Please fill in one form for each child you have.
Name (Parent/Guardian) *
Second Adult Contact (Name and Number)
Email *
Address *
Phone number *
Home Address *
Name (Child) *
Date of Birth (Child) *
MM
/
DD
/
YYYY
School and Year (Child) *
Child's phone number (if 16 or over) *
Any food allergies? *
Any medical conditions we need to be aware of? *
Doctor's Name and Number *
If I cannot be contacted and my child should require medical hospital treatment, I authorise an adult leader to sign, on my behalf, any written consent form required by the hospital. I understand however, that every effort will be made to contact me using the telephone numbers given above as soon as possible.
 *
In the event of illness or accident, having parental responsibility for the above child, I give permission for first aid to be administered when considered necessary by a trained first aider, if available, or medical treatment to be administered by a suitably qualified medical practitioner.
 *
CONSENT FOR PHOTOS AND RECORDED IMAGES

In accordance with our child protection policy, Safeguarding Trust, parents/guardians and are asked to give consent for the taking of photographs and recorded images. Consent may be withdrawn at any time by contacting the church.

I give permission for my child to be included in any photographs or videos which may be taken during the night. Photos may be used in Theology Ireland publications, website and social media.
 *
GDPR

We are committed to protecting your personal information.

By giving your consent, you are agreeing to allow us to hold and process your data for the purpose of contacting you with regards to up coming events run by Theology Ireland for children and young people.
Please let us know if you agree for us to contact you about future events for children and young people, and events in the life of Theology Ireland again.
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms