Buckfastleigh Consent Form

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Young People's Information

Email *

For the safety of the young people we need to make sure you're aware that this is an open access session. This means young people are free to drop in and leave whenever they choose and when they leave they are NOT being supervised. Workers must always remain in the session. If you would like your young person to stay in the session then please make them aware of this and check the box below and speak to one of our workers. *

I am aware its and open access session and happy for my young person to come and go as they choose

I would like my young person to remain in the session until collected

I give consent for my young person to walk to and from Youth Club at 'Old Totnes Road' crossing the B3380 *

Yes

I will drop off and collect young person after the session

Young Person's Forename *

Young Person's Surname *

DOB *

YYYY

Address *

Postcode *

Medical Needs *

I give consent for ..... *

Consent for Sessions

Consent for Photos

My young person to go outside (this session is open access)

Required

Notes:

Parent / Carer Name *

Parent/Carer Number *

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This form was created inside of Totnes Rural Area Youth Engagement (TRAYE) Project. Report Abuse

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