Does the participant suffer from any allergies etc (e.g. asthma, diabetes, epilepsy, nut allergy).
Read and accept the Terms and Conditions
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The information you provide will be treated as confidential, however it may be shared with partners.
Your Child information may be shared with other professional if we feel the child/ young persons at risk.
At times the Hollings Youth Association (HYA) may wish to take photos or videos of the group or individuals. We will ensure that the photos are safe and respectful and used solely for the purposes for which they are intended.
The photographs may be used in the following manner: Displays, promotion and celebration of a project or organisation.
The Photo’s may be used in magazines, newspapers, on the internet or on posters and leaflets.
The Photos maybe shared with HYA funders for evidence purposes.
HYA does not provide transportation for weekly activities; therefore, all parents/carers are requested to cater for their own child’s transport.
Occasionally we may provide transport. Parents/ carers will be informed by phone or latter.
There may be occasions when your child is involved in a planned and structured activity, such as a trip to the Theme Parks, bowling or participating in a fund raising event. The Organisation will have collected appropriate information in preparation for the activity (e.g. about the journey, the children’s various needs and helper skills), identified any potential risks or dangers, minimised the risks and dangers by careful planning and precautions and make sure we know who is responsible for putting precautions into place (E.g. who will carry the First Aid kit). This process is called a risk assessment.
Consent of Parent or Legal Carer
I give consent for my son/daughter to participate in HYA’s activities and agree to the conditions outlined above. I accept that it is my responsibility to inform HYA directly of any changes to the details recorded on this form.
If you have any additional information which you wish to share with the Organisation, please contact the Organisation Designated Person.
Participants not abiding by the code of behaviour or following instructions, may be asked to leave the programme/activity. I understand that in such circumstances HYA will not be responsible for the subsequent travel arrangements to return home. I understand HYA will do everything in its control to protect personal possessions but cannot be held liable for any loss or damage.
I understand that the group leaders will not be held responsible for any loss or damage caused to my child’s accessories. H.Y.A cannot be held responsible for any injury suffered by my child during or as a result of the activity.
If return via email you do not need to put a signature, your email will be used as an electronic signature.