Growing Works - Consent Form

Growing Works Young Person's Participant Form

The survey will take approximately 5 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.

To confirm your booking, please complete one form per child who will be attending.

Sprout - Strong Parents Reaching Out
A social group for SEND families with outdoor activities. Parents or guardians are required to attend the full session with their children.

Young Shoots
Outdoor sessions for young people (13 years old and over) with SEND to build independence and confidence, developing life skills and team working. Parents or guardians are not required to attend the session with their children.

Which activity session are you attending:

About the young person

Child's first name

Child's last name

Child's other name(s) Please include full name and indicate the name they like to be known as if it is different e.g. Isabel Smith known as Izzy

Child's gender

Child's Date of Birth

My child has 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.

Does your child have mental ill-health?

Does your child have a long-term medical condition?

What 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 they may have.

Can you tell us about the young person who will be attending? Please tell us a little about your child

How can we help your child feel comfortable? Please use this space to tell us things that help your child to settle in new surroundings e.g. what may upset them and how we can help them settle.

About you, the parent / guardian

What's your relationship to this young person?

Your name

Your address

Your phone number

Confirm your phone number

Your email address

I give my consent for Growing Works to use photographs taken of me or my child 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

I give my full consent for the participant stated above to attend sessions delivered by Growing Works. 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?