Parental Consent

Parental Consent Form

By completing this form, you are giving consent for your child to take part in activities at Ivy Church.

Child/Young Person's Details

Name *

Address

Date of Birth *

Gender

Person with Parental Responsibility

Name *

Address

If different from child

Mobile *

Please list any relevant food allergies or dietary requirements

Please list any medical conditions or additional needs of which we should be aware

How can we support your child/young person?

Photographic Images

During the course of our regular activities we may take photographs to be used both on the church website and in future event publicity. In order to publish an image of your child we need parental permission. All such photographs will be handled in accordance with our Safeguarding Guidelines and we will NOT publish any names or personal information.

I grant permission for the church to publish images of my child in promotional publications, the church website and social media channels.

If you do not give permission for your child’s photo to be published, please make sure that your child is aware of this.

My child in an individual photo *

Yes

My child in an group photo *

Yes

Signed *

Parent/guardian signature required

I accept your Ivy Church Privacy Policy