Annual Parent Consent Form
(Autumn 2023 - Summer 2024)

Dear Parent/Guardian,

We warmly invite your son/daughter to participate in our activity programme. Please complete this Annual Parent Consent Form to help us as we do everything we can to help them have a fun, safe and meaningful time.

Thank you, 

Young Life International Team

Sign in to Google to save your progress. Learn more
What does this Parent Consent Form cover?
All Clubs, Campaigners/Connect Groups, events/activities lasting one day or less throughout this current academic year. Your local YLI team will keep you informed about dates, times, locations, key activities, travel arrangements and any costs involved.

You will be asked to sign a fresh Parent Consent Form for any higher risk activities, overnight trips, multi-day events.

Young Person's Details
1. Full Name of Young Person(s) *
2. Young person's Date of Birth *
MM
/
DD
/
YYYY
3. Young Person's Home Address *
4. Young Person's Post Code / Eire Code *
5. Young person's school *
6. Young person's year group *
Parent's Details
7. Full Name of Parent/Guardian completing this form *
8. Parent's Phone Number *
Would you as the parent like to be add to our information text list on WhatsApp? *
9. Parent's Email Address *
10. If you're unavailable, who can we contact instead? *
11. Parent's home address (if different to the your son/daughter's address)
12. What is their relationship to your child?
13. What is their phone number?
Medical Details
14. Name of Doctor (or Doctor's surgery) *
15. Address of Doctor *
16. Phone number of Doctor *
17. Does your young person have any allergies/dietary requirements?  If yes, please explain, including the severity of requirements (ie: "my daughter is gluten intolerant so she avoids food with gluten"  or  "my son has severe Celiac Disease and cannot have any contact with gluten whatsoever")
18. Any current or recent medical details we should be aware of (including any contagious or infectious diseases that your son/daughter has suffered from in the last 3 months).
19. Does your young person have any medical condition that they have that they do not need to take medications for (e.g. autism, cerebral palsy)
20. Is your young person in process of being evaluated for a condition? 
[This helps our team to get a full picture when caring for your young person.]
21. Does your young person have any additional support needs that we should be aware of? Please give details.  Please also speak with your Area Director about any additional support needs.
22. Are there any reasonable adjustments you would like us to make to help us accommodate your young person well?
23. Details of any medication your son/daughter is currently taking, the dosage and whether it can be self-administered.
24. If needed, are you happy for YLI staff/volunteers to give your child: *
Yes
No
Paracetamol
Ibruprofen
Antihistamine
25. Date of last anti-tetanus injection (if known)
MM
/
DD
/
YYYY
Consents & Commitments
26. Are there any activities which your son/daughter may not participate in?
27. I give consent for YLI staff/volunteers to contact my son/daughter as part of their youth work duties, via the following electronic means and in accordance with our Electronic Communications Policy (available upon request). Please select all that apply. *
Yes
No
Text message
Phone call
Social media
28. If you selected "text message" or "phone call", what's your son/daughter's phone number?
29. If you selected "social media", please list which platforms you're happy with us using
31. I give consent for photos and videos to be taken of my son/daughter throughout any current and future activities with Young Life International or Young Life Ireland, which may be used on Young Life owned websites, social media and other online or offline fundraising and publicity material, according to our Electronic Communications Policy. *
32. Any comments, questions or concerns?
Parent's Declarations
Part A – Contingency Measures

1. In case of injury/illness, I give permission for a trained first-aider (where available) to administer first aid to my son/daughter as the first-aider considers necessary in the best interests of my child.

2. In an emergency, if I cannot be contacted, despite all reasonable attempts to do so by the leaders, I give permission for my son/daughter to undergo any medical/dental treatment, including the use of anaesthetics and blood transfusions, as considered necessary by the medical authorities. I acknowledge that any medical costs are my responsibility to settle.

3. I expect my son/daughter to behave in a manner that will not cause concern to YLI staff/leaders, that even though they will give the utmost priority to the safety of the young people in their care, they cannot be held liable for behaviour that leads to accident, injury, or increased health risks to others. I understand that if my son/daughter misbehaves, the organisers may forbid them from further participation and require me to collect them at my expense. If they cause deliberate damage to property, I agree to pay for the cost of replacement.

4.    I understand that YLI has a zero-tolerance approach to alcohol; weapons; and illegal drugs, solvents and substances. I consent to my son/daughter being searched according to our Prohibited Items Policy if there is reasonable suspicion that my child is carrying such prohibited articles.


Part B – Other Necessary Declarations

5. I understand the nature of the activities and associated risks and that the programme may include a brief Christian message. I give consent for my son/daughter named on this form to attend the event and fully participate, including any off-site excursions, except for any elements of the programme which I have listed above. I am aware that I can opt my child out of attending any aspect of our programme at any point, by contacting my local YLI staff person.

6.    I confirm that I am the parent/guardian of the Young Person(s) named on this form and therefore have full legal authority to make these Declarations.

7.    I understand that I am solely responsible for ensuring my son/daughter travels to and from each event, activity and meetup safely and on time, and in accordance with any transport expectations that are communicated by the YLI event organisers. The only exception is where prior arrangements have been made with me by YLI staff/volunteers to pick up/drop off my child, in accordance with the YLI Driving Young People Policy (available upon request).

8.    If at any point I have any questions or concerns, I will seek to address these as soon as possible by resolving them informally with my local YLI staff person or volunteer. I am aware that I can follow the YLI Concerns and Complaints Guidance at any point if I feel that a more formal process is appropriate. http://ylinternational.org/hr_resolving_concerns_complaints 
31. By typing my name in the box below, I agree that the information and declarations made in this form are true and correct. *
32. Date you completed this form
MM
/
DD
/
YYYY
Do you have other young people to sign up?
If there are other young people you have parental responsibility for, please register them using the link on the confirmation screen.
Privacy Statement
We care about your data privacy – find out more by reading our Privacy Notice: https://www.younglife.org/Pages/Legal/PrivacyPolicy.aspx.

Young Life International is a company limited by guarantee. Company Number: 04364093. Registered Charity Number 1090515 (England and Wales) and SC043473 (Scotland). Registered office, Kestin House, 45 Crescent Road, Luton, Bedfordshire, LU2 0AH. Young Life Ireland is a trading name of Young Life, a company limited by guarantee (company number: 638610), registered in the Republic of Ireland. Registered office: 388 North Circular Road, Phisborough, Dublin 7, D07T2R1.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Young Life. Report Abuse
Google Forms