Growing Works - Consent Form

Growing Works Adult Participant Form

The survey will take approximately 4 minutes to complete. Information and consent form for Growing Works activities.

For all sessions we request that you:
Please take responsibility for yourself and anyone in your care.
Report any accidents, near accident or incidents to a member of staff before leaving the site.
Respect each group members’ opinions, views, and cultural beliefs.
Do not take photographs of other people.

When attending Growing Works activities, we need to take details to ensure your safety.

Our Bud projects provides therapeutic gardening and outdoor activities for adults through volunteering, training and workshops. Sessions are open to all 18 years old and over including those with physical and mental health conditions; to enjoy the benefits of the outdoors and socialising in the outdoor environment.

If you would like to learn more about our work, or find directions to our site please click the following link to our session times and information page: http://www.growingworks.org.uk/session-times-information

Which activity session are you attending:

Your first name

Your last name

Your address

Your phone number

Confirm your phone number

Your email address

Your gender

Your Date of Birth

Tell us about you: use this space to tell us any information which can help us provide the best experience. Please include information on additional needs, emotional wellbeing, physical conditions and medical information including any allergies that affect you being in the outdoors and/or doing physical activity. Please include dietary allergies.

Do you have a Special Educational Need or Disability We are asking this to gather monitoring information for our funders - you do not need to have a diagnosis or EHC Plan to attend.

Do you have mental ill-health?

Do you have a long-term medical condition?

Would you like us to know about additional needs? Please use this space to tell us about additional needs and medical information that we need to be aware of. Please make sure to include any allergies that you may have.

Details of professional support (if applicable): Please provide name, organisation and contact details

What do you want to gain from Growing Works sessions? (Tick all appropriate)

Spending more time outdoors

Building social skills

Increased physical activity

Improved mental wellbeing

Give back to the local community

I give my consent for Growing Works to use photographs taken of me and/or our words taken in interview, to be used for non-profit promotional and information purposes.I understand that our photograph and/or our words may be used in various print or other media, locally or nationally, to promote and inform people about Growing Works activities. You can withdraw consent at any time by emailing info@growingworks.org.uk

GDPR Consent: In order to provide a professional and effective service we need to keep a record of personal information. This is information such as your name, contact details and relevant medical/SEND details. The personal data provided to us will only be used by Growing Works in order to provide its service to you and for monitoring purposes. Confidentiality is maintained except in the circumstances that may place a child or vulnerable adult at risk. I consent for my data to be stored by Growing Works to be used for the purposes outlined above and I understand that I can withdraw my consent at any time by emailing info@growingworks.org.uk

Where did you hear about Growing Works?