Consent Form 2017

PARENTAL CONSENT FORM

This section is to be completed by parent/guardian for children under 18 years of age

If completing by email – please complete in red.

I have read the terms and conditions and accompanying information about the Justwoods activities.

I am happy for …...... to participate and give my permission for:

*Please delete any of the statements below you do not want to give permission for*

  • Participation in all activities stated.
  • The audio recording of conversation
  • The use of photographs and videos in publicly-available reports and news articles for

promotional and educational purposes

  • The use of written research data for reports, presentations and publications.
  • Administering of First Aid and preventative measures i.e. application of sun cream.

Signed……………………………………………………………… Date…………………..…..……….

Print name …………………………………………...... Relationship to Participant......

Health and Personal Safety Questionnaire

To help us plan our woodland sessions and first aid provision please answer the following questions:

Is there any activity/task that the participant may find difficult for health or mobility reasons?

Is the participant taking any medication that a first aider or doctor would need to be aware of? Please specify below whether medication needs to be used during the session and is suitable to be self-administered.

Is there any information that we may need to ensure the participant’s safety (e.g. behavioural

issues, allergies, medical conditions)?

EMERGENCY CONTACT DETAILS: Participant’s details

Name ______Date of Birth______

Address ______

______

Doctor’s name and telephone number ______

______

EMERGENCY CONTACT 1

Name:______Relationship to child:______

Contact Number/s______

EMERGENCY CONTACT 2

Name:______Relationship to child:______

Contact Number/s______

In the unlikely event that my child is involved in a serious accident I expect to be contacted immediately on the above telephone numbers. In the event that my child requires immediate medical treatment before I can get to the hospital, I hereby authorise the staff member present to consent to any emergency medical treatment necessary to ensure the health and safety of my child on my behalf.

Signature ______Date:______

Information Sheet: Ticks and Lyme disease

What are Ticks?

Ticks are tiny spider like creatures found in grassy or woodland areas. They attach themselves to passing animals and people. They do this by finding a suitable spot where they bite through the skin and feed on blood. They will feed for 3-5 days then drop off.

What is Lyme disease?

Lyme disease is an illness caused by bacteria which lives in the gut of ticks. Most ticks do not carry the bacteria, but infection could be passed on if you are bitten by one.

How to prevent Ticks.

When at a woodland session, please ensure that your child has most of their skin covered. Trouser bottoms can be tucked into socks and sturdy shoes or boots should be worn, even in summer. A long sleeved top should always be worn to cover the arms. Insect repellents can also be used.

Please check your child over for Ticks when they return from Forest School; particularly vulnerable areas are where there are folds of skin, such as the armpit and also the scalp.

What to do if your child has been bitten by a Tick.

Remove the tick as soon as possible to reduce any chance of infection.

Grasp the tick as close to the skin as possible using fine tweezers and pull firmly and steadily out without jerking or twisting. Do not crush or squeeze the tick’s body.

If any part of the tick remains in the skin, remove with fine tweezers. Apply disinfectant to the area. If you are worried seek advice from your GP.

Signs and symptoms of Lyme disease.

The most common symptom is a slowly expanding rash round the bite, usually after 5 – 14 days. Other typical symptoms include fever, headaches, tiredness and rashes.

Most cases can be treated successfully with a course of antibiotics.

If left untreated infection can spread. Please consult your GP if you have any concerns.

Anna and Simon Anstead07817 176612/07854 821295

78 Downleaze South WoodhamFerrers Essex CM3 5SJ