Parental Consent Form

Contact Us

Child's Name

Child's Date of Birth

Emergency Contact Details - Name

Relationship to Young Person

Contact Number

Alternative Contact Name and Number

Checkboxes

I confirm that I (or another adult with parental responsibility) will attend this day with my child/young person

I acknowledge the need for my child also to behave responsibly and will ensure that this expectation to behave appropriately is fully understood by my child.

Does your child have any allergies or dietary requirements that we need to be aware of?

Is there any medical information that we need to be aware of?

Opt-In

Please tick each method of communication with your child that you consent to. Where you consent to electronic methods of communication, please provide your own account address so that you can be copied into the correspondence.

Young Person's WhatsApp Number

Your WhatsApp Number

New Field

I consent to the parish taking and using photographs of my child/children for use on the website and Social Media

Parent or Guardian's Name

Date

Parental Consent Form

Contact Us

Church of the Immaculate Conception

17 Coleshill Street,

Flint,

CH6 5BQ

Contact Us

01352 732245

priestflint@rcdwxm.org.uk