Girls Friendly Society
Off-site trips/event Consent Form
Name of event/trip
Daughter’s First Name Daughter’s Surname
Date of birth
Next of kin/emergency contact details 1First Name
Surname
Telephone (H)
Telephone (M)
Address
Relationship / Next of kin/emergency contact details 2
First Name
Surname
Telephone (H)
Telephone (M)
Address
Relationship
Medical Information
Does your child suffer from any of the following?
Asthma □ Epilepsy □ Diabetes □ Heart Condition □
Other medical condition □
Please give details
Does your child suffer from any allergies? (For example: hay fever, Nuts, eczema)
Yes No If yes, please explain:
Is she taking any medication at the moment? Yes No
If yes, please give details:
Has your child received a tetanus injection in the last five years? Yes No
If yes, please give date if known.
Does she have any special dietary needs? Yes No
If yes, please give details.
Is there any additional information to note about your child? (e.g. ability to cope with being away from home, toileting difficulties, special equipment or aids to daily living)
Yes No If yes, please give details.
Name of GP
Surgery address
Surgery phone number
Transport
My daughter will travel to and from the activity by:
Transport organised by GFS
We will make our own transport arrangements
Driven by a GFS volunteer or staff member in their car
My daughter will make her way home by
We will collect her from the agreed meeting point
She will walk home
She will use public transport to get home
Driven by a GFS volunteer or staff member in their car
Hazardous Activities – only complete if applicable
Parent/Guardian Consent - please read each section carefully
· I consent to the administration of medical treatment to my child if necessary whilst participation in off-site GFS activities. I agree to inform the GFS group leader if my child’s medical circumstances change prior to the trip.
· I consent to the attendance of my child on this off-site Girls Friendly Society trip/event when the persons in charge of the young people will be an employee, volunteer or agent of GFS and agree to the conditions detailed.
· I confirm that my child is physically fit and capable of full participation in this trip/event, including any hazardous activities highlighted above.
· I consent to photographs and video being taken of my child while participating in GFS activities to be used for promotional and publicity purposes, including social media, and to record their achievements Yes No
Name of parent / guardian:
Signed: Date:
Date:
Dear Parent/ Guardian,
The (insert name of Project or Branch) are planning a trip for (X) girls and young women to (insert venue for the offsite trip) on (insert date / time of the offsite trip). The offsite trip is to (insert the purpose and what the trip hopes to achieve for the girls and young women)
The activities being planned for the girls and young women include (insert ALL the activities to be undertaken during the offsite trip).
We will be travelling by (insert mode of transport) from (insert meeting point include address and time of departure) and arrive (insert date, time and meeting point include address if different). You will be responsible for ensuring that your daughter arrives and is collected from the meeting point on the date/ time stated above.
(Insert any other information that the parent should be aware of e.g. – Lunch arrangement i.e. packed lunches in disposable bags, buy own lunch or lunch provided, equipment, contribution from parents, suggested amount of spending money and purpose, appropriate clothing / shoes etc.)
Please use the contact details below should you wish to contact the group leader or (Insert name and contact details of the Home contact) whilst your daughter is on the trip.
If you would like your daughter to take part in the trip then please complete and return the attached Offsite Trip consent form by (insert date for the return of completed consent forms).
(Insert any other information – e.g. Limited spaces, first come first served basis, no travel without the signed consent form, whether further contact will be made nearer the date),
I look forward to hearing from you soon.
Kind Regards (or whatever you wish)
(Insert Signature of Group Leader)
Insert Name of Group Leader:
Name of GFS Group:
Contact details: Telephone / mobile and email address (very important especially if this letter is the only form of communication with the parent / guardian
A14 Off-site Trips Policy Form 2