Consent Form

This consent form is to be completed by the parent/carer/legal guardian of the young person in preparation for IGNITE resuming face to face.

If you have more than one child/child in your care please complete this form separately for each young person.

One part is to be completed by the young person.
Each section is clearly marked.

Consent forms are updated annually (September) and this updated consent form includes details regarding the COVID-19 Track and Trace service.

Each young person needs a completed form before they attend IGNITE.

IGNITE Youth is part of St Michael’s Church, Rossington in the Diocese of Sheffield.

IGNITE Youth is organised by our Centenary Project Youth Worker Hannah Robinson who can be contacted in person, via the church above, by phone on 07875500555, by email at hannah@centenaryproject.org.uk, or on Facebook as Hannah YouthWorker.

Please do store this information so that you can contact us, particularly in an emergency.

You can also contact us, find out information, or follow our updates on social media:

Facebook: @igniteyouthgrouprossington
Instagram: @igniteyouthgrouprossington
Twitter: @igniteyouthrosso

Each of these accounts is updated and monitored by Hannah Robinson.

Your privacy is important to us and we would like to communicate with you about the church and its activities. To do so we need your consent. Please complete the forms below and confirm your consent by ‘signing’ below. You can withdraw or change your consent regarding communication at any time by contacting the group leader.

You can find out more about how we use your personal data by reading the privacy notice which you can find on the church website: http://www.stmichaelsrossington.co.uk

Young Persons Information
To be completed by the parent/carer/legal guardian of the young person

Full Name of Young Person(required)

School/College attended by Young Person(required)

Date of Birth of Young Person(required)

Address including postcode(required)

Please provide details of a medical nature or disability which may affect participation (required)

Does the participant suffer from any allergies? If yes, please specify(required)

Please detail any medications the young person is on.Please also provide details of any medication required during the time of the activity. This should be clearly labelled and handed to the group leader at the beginning of the activity. If the parent /carer wishes the medication to be administered by the group leader, please discuss with the leader and specify in writing the time(s) and dosage required.(required)

The following details will be used in case of emergency and provided to Track and Trace if requested

To be completed by the parent/carer/legal guardian of the young person

Next of Kin Name & Relationship to Young Person (required)

Next of Kin Phone Number(required)

Next of Kin Email Address(required)

The following details will be used in case of emergency
To be completed by the parent/carer/legal guardian of the young person

In an emergency and/ or if I am not contactable I give my permission for the participant to receive any necessary dental, medical or surgical treatment, including anaesthetic.

Sign & Date(required)

Please provide a 2nd contact should the next of kin be uncontactableFull Name & Relationship to Young Person(required)

Contact Number(required)

Parent / Guardian Consent
To be completed by the parent/carer/legal guardian of the young person

I give permission for the above-named person (the participant) to take part in the activities of IGNITE Youth

I acknowledge that if any changes happen to the details on this form I will inform the group leader as soon as possible so that information can be kept up to date

I give consent for the participant to be in photographs and videos, which may be used for publicity, including on social media across the Diocese of Sheffield

I consent to the group leader contacting the participant via mobile phone regarding any group activities, events or meetings; providing the participant provides this contact number

I give permission for the group leader to contact myself or the participant via social media, if we are connected with them in that way. E.g. via Facebook, Instagram or Messenger. (Please note the group leader will not initiate friend requests and other forms of contact on social media. This will need to come from yourself or the participant).

I consent to receiving information regarding trips, socials or groups etc. via post. Please use the given address

I consent to receiving information regarding trips, socials or groups etc. via email using the given email address

Signed(required)

Young Person (Participant) Consent
To be completed by the young person

I acknowledge that if any changes happen to the details on this form I will inform the group leader as soon as possible so that information can be kept up to date

I give my consent to be in photographs and videos, which may be used for publicity, including on social media across the Diocese of Sheffield

Social media would usually be used for this purpose but I am happy to receive reminder text messages about group activities and I am happy for the group leader to contact me regarding any group activities, events or meetings if necessary – please add your number below if you consent to this

Phone Number

I give permission for the group leader to contact me via social media, if I am connected with them in that way. E.g. via Facebook, Instagram or Messenger. (Please note the group leader will not initiate friend requests and other forms of contact on social media. This will need to come from yourself).

I consent to receiving information regarding trips, socials or groups etc. via post using the address above.

Signed by the Young Person(required)

Any other information to add

Date Form Completed(required)

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