Clip 'n' Climb Consent Form

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This form is to be filled in by a parent/guardian

Saturday 30th October 10:00-11:30 am
School years 3-11
£14.50

We will meet at Clip 'n' Climb's reception area at 9:50 am ready to climb at 10:00 am. Pick up: 11:30 am.

Address: Clip 'n' Climb, 34 Clifton Road Industrial Estate, Clifton Road, Cambridge, CB1 7EB

I have already completed a basic youth consent form and checked that all the information up to date *

Yes

If you have not completed a basic consent form or the information needs updating, please copy and paste the link below into a browser to fill in a new consent form

https://forms.gle/3g1J3omtiPKE1TbRA

Who will be collecting the young person from the venue? (You must notify us if this changes) *

Guidelines

Young people attending the Clip 'n' Climb Trip should:
- Only attend once the consent forms have been filled in (basic consent form and this form)
- Dress appropriately for the session
- Not use inappropriate language
- Listen and respect everyone else

Anybody breaking these rules will be asked to leave and the parent/guardian will be contacted.

I agree to these guidelines and have explained them to my young person: *

Yes

Parent/Guardian Declaration

I give consent for my child to participate in St Andrew’s Stapleford Youth Group Clip 'n' Climb trip. St Andrew’s and its staff and volunteers will take all due care & responsibility for my child’s safety and welfare, but I recognise that St Andrew’s Stapleford is only liable for injury caused by their negligence. St Andrew’s has insurance for such an eventuality but does not otherwise provide personal insurance for participants.

I agree to this declaration *

Yes

Required

Payment

Please pay £14.50 by bank transfer to the church account.

Name: Stapleford Parochial Church Council
Sort code: 30-91-74
Account number: 01263363
Reference: Please use your young person's name as the reference

I have transferred £14.50 *

Yes

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