Oxygen Youth Registration/ Consent Form

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Oxygen is a youth work charity and is identified as providing a range of services to young people during the Covid-19 pandemic and as we move out of lockdown. All its staff and volunteers are D.B.S. checked and have undergone approved safeguarding training. You can find out more information about Oxygen at www.oxygen-online.org

We provide a range support to young people who attend our youth clubs and projects and those referred to us by schools and other services working with young people. This form needs to be completed for any young person attending Oxygen projects or receiving direct support from the Oxygen team.

This might take place via text, phone call, Whatsapp, virtual video call, or in some cases 1-2-1 socially distanced meetings outdoors or by appointment at a youth club or other Oxygen venue. Some of our work is funded by or delivered under a contract with other agencies including Achieving for Children, London Youth, and the GLA with whom we share information for monitoring and evaluation purposes. All communication is monitored by the Oxygen management team.

Email *

Parent/guardian name *

I give consent for Oxygen to retain the information on this form for the purposes of supporting my son / daughter. If you do not give consent here then we cannot provide support. If you are concerned then you can discuss this further with a member of the Oxygen Team. *

Yes

Required

I give consent for my son/daughters details to be shared with Achieving for Children. This is necessary for monitoring purposes on projects where funding is provide by AFC for Oxygen to deliver its work. *

Yes, I am happy for information to be shared

Yes, but just their Name and date of birth

I would like to discuss this with someone please before deciding

No (This may have an impact on what clubs or activities your son/daughter can attend.)

Parent / guardian's contact number *

Your relationship with the young person named below: (father, mother, etc) *

Young person's name (in full): *

Young person's date of birth *

YYYY

Address: *

Post code *

What school / college does the young person attend?

What year group is the young person in?

Is the young person eligible for free school meals?

Yes

Clear selection

Dietary Requirements *

Any allergies or medical conditions *

Yes. If so please give details below

Required

Details on allergies or medical conditions including medication:

Name and address of GP *

I give consent for photos to be taken and used by Oxygen to demonstrate the work of the charity. *

Yes

Clear form

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