Parental Consent Membership Form

(To be completed for all under 18's by the their parent/guardian/carer)

*Please note that if you wish for us to no longer store your data, please email this request to contact@aptitude.org.uk

Identity

Forename

Surname

Nickname

DateOfBirth

Demographic

Gender

Ethnicity

Social Worker or Early Help

Please write Name and Contact email and Phone number for Social Worker or Early Help Family Hub worker?

Address

School

Address1

Town

Post Code

Contact

Parent Contact Telephone

Parents name

Young persons contact number

Medical

Please tell us about any illnesses, allergies or other medical information which you would like to describe here:

Permssions

Do we have your permission to administer First Aid to your son or daughter?

I have read, understood, and accepted the COVID Risk Assessment

I have read, understood, and accepted the privacy policy. I have explained to my child the rules for behaviour.

Do you give Aptitude Organisation CIC full permission to use images of my child during youth activities, the use of these images from photographs/video filming, for promotion and fundraising online.

Activities

Please tell us which session(s) your child will be attending:

Membership form link