Consent Forms

Treads Youth Advice & Information Consent Form
Dear Parent or Carer,
Your young person has expressed a wish to take part in activities at Treads, Blandford Youth Centre, United Reformed Church, Whitecliff Mill Street, Blandford Forum, DT11 7DQ. The name of the Team Leader of this project is Libby Lloyd who can be contacted via 07552724840 during sessions. We require parental consent for any person under 18 to engage with the activities we offer (Section 1). In addition, due to the General Data Protection Regulations we are required to ensure we have provided a Privacy Notice (Section 2) Please sign and return this form as soon as possible to Treads,  youthsupport@treads.org.uk.  Without all elements of this form being completed, signed and returned, we regret your young person may be unable to participate in the activities available.
Please complete section 1 & 2 of this form.
Section 1 All staff hold a clean DBS certificate and received training in safeguarding. Each team has a qualified first aider and certificates in food handling.
Many different activities form part of a routine youth work programme.
Conduct: In order for all young people to have an enjoyable time there have to be certain ground rules that must be followed at all times. These include participants not behaving in a way which places a young person, member of staff or member of the public at risk (for example bullying, vandalism, the use of drugs or alcohol) We ask for your support in ensuring these rules are adhered to. All young people aged 12+ most inform the youth workers and sign out when they leave the premises.
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Photographys, digital images and video: We may take individual or group photographs of participants in activities which will then be used for promotional materials, displays, press articles, presentations, funders reports and on the Treads Blandford Forum website and social media. A member’s name will never be included with a photo or a video. Please note it is possible that photos may be used after the young person has stopped using our services. In order to comply with the Data Protection Legislation, we require your permission for your daughter/son/young person you have responsibility for to be photographed or videoed in this way. Please complete section 2 Privacy Notice. NB: Many young people own their own and use a personal smart device. Treads cannot be responsible for any images or videos taken and uploaded to social media by member’s friends and peers.
Medical issues: If there are any medical issues or conditions e.g. allergies staff should be aware of please note in the box below. (Please see privacy notice)#
Additional Information:Is there anything concerning you young person’s identity (religion, beliefs, heritage and culture) that it would be useful for staff to be aware of. If so, please fill in the box below. (Please see privacy notice)
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Are there any other organisations or agencies that are currently working with your young person that you feel it would be beneficial for your young person for us to be aware of? This is so we could work together with those agencies to support your young person.
Consent: I have read, fully understood and am satisfied with the details supplied about the above mentioned activities and agree to my daughter/son/young person I have responsibility for taking part in them. I know of no medical or non-medicl reason why they should not participate and I am happy with arrangements outlined regarding photography and behaviour.
I am aware that: Treads Advice & Information centre is an open door organisation. Your young person, once they have signed in can come and go as they please. Treads staff do not have the right to make them stay at Blandford Youth Centre. I must inform Treads staff of any important changes to my daughter/son/young person’s health/medication/or needs and also any changes to their address, phone number given.
Young Person’s Name:……………………………..Date Of Birth…………………….….
Address……………………………………………………………………………………...………………………………………………………………………………………………..……
…………………………………………………………………………………..………………
Phone….………………………Email……..………………………………………………….
I would like to be kept informed of upcoming events, activities and information about Treads Yes …….No ………..
Parent/Carer’s Name:………………………………………………………………………...
Emergency Contact Number(s)…………………………Relationship to Parent/Carer’s
Signature:…………………………………. Date: ………………………………………..
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Please Complete Section 2
Section 2 Privacy Notice (GDPR) Youth & Community Work
Privacy Notice 
Treads Youth Advice & Information Centre is committed to the security of personal data held about users of its services (information) To be able to provide youth and community services we need to collect and process data to fulfil our role. This privacy notice explains the data we need to collect and how we will use it.
Who we are 
Treads Youth Advice & Information Center is a charity working in Blandford Forum and surrounding areas serving the local communities to improve outcomes and enable young people to reach their full potential. Our registered address is
Treads Youth Advice & Information                                                                       c/o United Reformed Church,                                                                             Whitecliff Mill Street,                                                                                         Blandford Forum                                                                                                   Dorset DT11 7DQ                                                                                                       Tel 07552724840                                                                                                                    www.Tread-youth-blandford-forum.com
Youthsupport:@treads.org.uk
What data do we ask you for? 
As part of the registration process for our workshops and activities we ask for information about the young person who wishes to take part. If the young person is under the age of 18 we require the signed consent of a parent (or person with parental responsibility) to record and use this information. We will ask for some general data including but not limited to:
· Name   
· Address    
· Date Of Birth   
· Phone Number    
· Email Address               
· And any other general information necessary to provide services to you                   
· Emergency contact details – name, address and phone numbers                 
· Other general data
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We also ask whether the young person registering has:
· A medical or physical disability
· Any medical conditions
· And anything else in relation to them which could indicate risk to themselves or others We do ask about a young person’s identity (sexuality, beliefs, heritage, culture) but this is optional and they do not have to tell us. However, if they choose to tell us about this it would be treated with the same confidentiality as the data that we do ask for.
As part of the monitoring of our services we may also ask about ethnic background. These types of data are called special category data and are treated in the strictest of confidence.
During the time that young person engages in Treads workshops and activities there may also be notes made by the youth workers to record behaviour and engagement in activities. This information may include support assessments and risk management plans. There may also be letters, notes from one to one meetings and any other documents created as part of our services to those who register.
From time to time there may be also other data that we need to ask for if you take part in any additional activities and where we need to provide support in applications to other agencies. If this is required we will contact you to request consent.
Treads like to promote the work and activities of our organisation, via social media, newsletters, press, annual report and other marketing activities. Therefore, from time to time staff might take photos or videos which contain the image of the young person you are completing this privacy notice on behalf of. These will be stored securely on our computer system to which access is restricted.
What purpose do we use the data for? We may need to collect the young person’s data for monitoring purposes to satisfy our funders (eg Postcode lottery). The data will be used to provide statistics and generate summaries, it will not contain personal data. The data will also be used to inform decisions such as the allocation of resources and support and to set targets for our staff ( your young person cannot be identified in these statistics)
The data we request enables us to keep a record of the young person’s information and access this to fulfil any other requirement to provide services to them.
We collect data on a set of paper forms, completed when first registering with Treads. From time to time we may keep other general paper records, for example (but not limited to) copies of letters we send to you or forms that we may have helped with.
We also store this information electronically on our computer system. Access to these records is password protected and restricted only to members of Treads Blandford Forum and Community Team who may need to access this information to carry out their role.                   -5-
This data is collected under the lawful purposes set out in General Data Protection Regulation of: 6(1)(b) Processing is necessary for the performance of a contract with the data subject or to take steps to enter into a contract.
On occasion we may also use the data for other reasons such as applying for funding to increase the service and opportunities for young people.
We would like to be able to offer the best service we can so in addition to the basic performance of providing you young people’s workshops and activities please would you also give your consent for us to contact them about additional services.
The purpose is set out in General Data Protection Regulation: 6(1)(a) Consent of the data subject
In addition to the general data that we ask you for there will also sometimes be some special category data that we need to request from you including (but not limited to) medical requirements, religion, heritage, drug or alcohol issues and details of any criminal convictions. This is essential to assess the level of support that may be required and to ensure the wellbeing of everyone involved in the project.
The lawful basis for this is under GDPR is covered by:
9(2)(c) processing is necessary to protect the vital interests of the data subject or of another natural person where the data subject is physically or legally incapable of giving consent.
If you would like to share information about any other special category data we will treat it with the same confidentiality as we do all special category data.
The lawful basis for this under GDPR is covered by: 9(2)(a) explicit consent of the data subject, unless reliance on consent is prohibited by EU or Member State law
Will we share the data? 
Treads do not sell on any personal data that we hold and we treat all this data as strictly confidential. We will only share the young person’s personal data if we have consent, with the exception of a medical emergency where it may be necessary to protect their vital interests or where there is a legal or statutory duty to do so (for example, but not limited to, carrying out our statutory duties with regard to child protection, for anyone under the age of 18 years old)
On occasion we may also need to share some data with other agencies. In the interest of the safe guarding of young people that Treads work with, we may share information about the young person with other agencies such as schools, police and social services.
How long will you keep this data? We will keep all forms, documents and software accounts for the whole period that the young person engages with Treads services.
After the young person stops using our services, we have a statutory obligation to keep their data.                          -6-
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If they are care leaver we have a duty to keep their information for 75 years after they have left the service. If they are not a care leaver, we will keep their information for 10 years.
This would include accident, incident, child protection and safeguarding information. Financial records will be kept for seven years after the leaving date.
Where will you store the data? All paper documents are kept in locked filing cabinets with access restricted only to Treads staff who require access to fulfil their role. Access to electronic records and software accounts is password protected and user accounts are only created for staff who require access to fulfil their role. Once staff leave our employment their access to this information is withdrawn.
Your rights and your personal data: Under GDPR you have the following rights (unless subject to an exemption):
1. The right to be informed
2. The right of access
3. The right to rectification
4. The right to erasure
5. The right to restrict processing
6. The right to data porttability
7. The right to object
8. Rights in relation to automated decision making and profiling
WITHDRAWAL OF CONSENT
If you or the young person you are signing for would like to withdraw consent to the processing of the data that may only be processed with you/their consent please put this in writing to Treads. Please specify the area of consent that you/they wish to withdraw and any other relevant information. If you would like to use your/their right to erasure it will result in us being unable to provide young people workshops and activities, if requested before leaving our services.
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YOUR CONSENT: (Please tick the boxes)
[  ] I have read and understood this privacy notice
[  ] I give my consent for Treads to contact both me and the young person I am signing for with details of other activities or support available
[  ] I give my consent for Treads to share data with other organisations/agencies as Required. This maybe necessary for us to access other services on behalf of your child.
[  ] I give consent for Treads to take photos/video of the young person named below To be used for marketing and promotional purposes in the following media
[  ] Social Media
[  ] Newsletters
[  ] Website
[  ] Newspaper articles and other media
[  ] I am aware the organisation may use this material after the young person has left the services.
[  ] I give my consent for Treads to collect and store special category data such as that of religious beliefs where it relates to the requirements I would like the Centre to observe.
Name of young person …………………………………………………………….
Date of birth ………………………………………….
Name of parent/person with parental responsibility for the above name person
…………………………………………………………………………………………….
Signature……………………………………………. Date……………………………
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Confidential Medical Information Young Persons
Full Name……………………………………………………………………………………...
Young Persons Date Of Birth………………………………………………………………..
Home Address………………………………………………………………………………... ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. Email Address………………………………………………………………………………… Contact Telephone Number Home…………………………….. Mobile…………………
Alternative emergency contact person name and telephone number ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………….. Does your child have any of the following:
Does your child have any specific dietary needs………………………………………… ………………………………………………………………………………………………… Has your child received medical or surgical treatment of any kind from either your family doctor or hospital during the past 3 months……………………………………….
Has your child been given specific medical advice to follow in emergencies?............ If the answer to any of the questions above is Yes please give details here: (including dosage of any medicines/tablets)……………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………….. I agree to my child receiving first aid in an emergency situation
Signed ……………………………………………………………………………..………..
Relationship to child…………………………Date………………………………………..
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