General Consent Form printable pdf download

General Consent Form

GENERAL CONSENT FORM

In the interest of your child, it is important that you should sign this consent form and

declare any known medical conditions and any medication that he or she may be

receiving. It is also important that youth leaders are made aware of any court orders

in relation to your child. Should this be applicable, please indicate the nature of the

order below. [To enable ease of retrieval during activities both at ……………………… and

on any trips out, this information will be stored on an Excel Document on a PC. Please

indicate your consent to this (or otherwise) at the bottom of this form].

Name of young person _________________________ Date of Birth _____________

Address:

____________________________________________________________________

Any known medical conditions

____________________________________________________________________

Food allergies or special dietary requirements _______________________________

____________________________________________________________________

Details of any court orders ______________________________________________

Your contact phone numbers (include dialling code)

Home _______________________________________________________________

Mobile _______________________________________________________________

Work (if applicable) ____________________________________________________

Email address _________________________________________________________

Additional contact & contact phone numbers (if the above is not available)

Name _______________________________________________________________

Mobile No ____________________________________________________________

Home No ____________________________________________________________

Work (if applicable) ____________________________________________________

General Consent Form