Revolution Youth Consent Form 2023/2024 • Green Pastures Church

Please update your young person's consent below.

First Name *

Last Name *

DOB (dd/mm/yyyy) *

Gender *

Young Person's Mobile Number

Home Address *

Home City *

Home Postcode *

Have you moved house in the past year? (Y/N) *

Allergies/Medical Conditions/Additional Info

School Attended *

Class *

Parent/Guardian Name *

Parent/Guardian Mobile Number *

In order to ensure the safety of your young person while in our care, we require your consent for the following:

Permission for your young person to take part in the normal activities of Green Pastures Youth.
In the event of illness or accident, permission for the application of medical or first aid by appropriate persons.
In the event of your young person needing emergency hospital treatment, we will endeavour to contact you immediately.

*We would also ask that you ensure your young person is aware of their own travel arrangements prior to all youth events. Pick-up times will be communicated ahead of all events and we would ask that you collect your young person at that given time.

Please tick for consent for:

permission for photographs or videos of my young person to be taken for church use.

Please tick for consent for:

your young person to be added to a WhatsApp group with other young people & assigned leaders

Parent/Guardian Signature *

Date (dd/mm/yyyy) *