Parental Consent Form - Trinity Trust Team

Young Person's / Child's Details

First Name

Last Name

Date of Birth

School Year

Year

Medical / Allergies

When your child is in our care, it would be helpful to know whether he/she suffers from any allergies, is on particular medication or whether there is anything else you would consider important for us to know

Address Line 1

Address Line 2

City

County

Post Code

Your Details (Parent / Guardian)

First Name

Last Name

Phone/Mobile

Who do you authorise to collect your son / daughter?

Just myself

Myself and others

Name(s) of authorised person(s) who will collect your son/daughter:

Authorised person name

I give permission for to attend and take part in .

I give permission for TTT to contact me about using the details I provide.

Photo consent

We often use photos of the team working with groups of young people to promote the work we do, via posters, flyers, presentations and/or our website. Any photos taken will be stored on the Trinity Trust Team computer at our office, and used only for the purpose above.

I consent

I do not consent

If it becomes necessary for to receive medical treatment (other than any listed under the allergies disclosure) and I cannot be contacted, I hereby give my general consent to any medical treatment, including anaesthetics and authorise the leader in charge to sign any documentation required by hospital or other authorities.

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