Youth_club_registration

Child’s personal details:

Full name of Child

Date of Birth

Gender MaleFemale

Child’s Home address:

Postcode

Parents’/carers’ details/Emergency Contact:

1) Name of the parent/Carer

2) Name of the parent/Carer

Relationship to child:

Home address:

Postcode:

Your email

Telephone

Booking Information:

I am: StudentRefugeeAsylum seekerUnemployed

Child’s medical information/individual needs:

Known medical conditions, allergies, special dietary and health needs: YesNo

If yes, please give details

Details of any medication being used:

To the best of your knowledge has your child been in contact with any contagious or infectious diseases, or suffered anything that may be, or become contagious or infectious? YesNo

If yes, please give details:

Photographs and videos:
The issue of child safety is taken very seriously at Restorative Justice for All. This includes the use of images of children. These may be used for display/training purposes within the playgroup.
Including images of children in Restorative Justice for All publications and on Restorative Justice for All’s website can be motivating for the children involved. However, we have a duty of care towards children, which means that children must remain unidentifiable, reducing the risk of inappropriate contact, if images are used in this way.
We ask that parents consent to Restorative Justice for All taking and using photographs and images of their children.
We will never include the full name of the pupil alongside an image.

Permission for Photographs and Digital Images

I consent to photographs and digital images of the child named below, appearing in Restorative Justice for All publications/website. I understand that the images will be used only for educational purposes and that the identity of my child will be protected.

We/I give permission for my child to be photographedWe/I give permission for my child to be videoedWe/I give permission for my child’s photograph/video to be placed on RJ4All’s website