Arena Kids Church Consent Form

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Email *

Arena Campus *

Ilkeston

Mansfield

Belper

Full name of child/young person *

Date of birth *

YYYY

Address *

Details of any regular medication, medical condition (eg asthma, epilepsy, diabetes, allergies, dietary needs, etc) or disability which may affect joining in kids church activities

Name of parent/carer/grandparent *

Address (if not same as above)

Tel number (mobile) *

It is important to us in Kids Church that your child feels that they are safe and secure. To help us achieve this, please tell us a little more about your child.

What do they prefer to be called? (Should we shorten their name?)

At school, does your child receive any extra help from a member of staff to enable them to fully integrate with school life, either physically, emotionally, or educationally? If YES, you will need to have a short meeting with a Team Leader to discuss your child's additional needs and the availability of our team members. *

Yes

Are there any activities your child really dislikes? If so, please give details.

Tell us anything else you feel is relevant about your child that will help the Kids Church team.

Please inform a Kids Church team member should there be any changes in circumstance.

I give permission for photos to be taken and to be used internally and externally including: promotional items, social media, church website *

Yes

I consent to Arena Church storing my information for administrative purposes and for contact in emergency situations. *

Yes

Consent

I understand that while involved he/she will be under the control and care of the group leader and/or other adults approved by the place of Arena leadership and that, while the staff in charge of the group will take all reasonable care of my children, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during, or as a result of, the activity.

If your child should need medical help, the parent/carer will be contacted and advised of the situation as soon as possible for you to take to A&E or other medical services.

Please TYPE YOUR NAME as a digital signature to accept all of the above *

2022 - 2023 Refresh Consent

I have read and made updates to the above consent form as needed and agree with all herein.

Signed Name: ___________________________________________________________________

Date: ________________________________

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