© Girlguiding 2014 Information and Consent for Event/Activity 1 of 2
Name of event
Part I – to be completed by the Leader. The parent* should retain a copy of all the information in Part I.
Please return this form to (name)
By (date)
Proposed activity(ies)
Start date and time
Finish date and time
Cost Travel/transport information
This is a large-scale event (100 participants or more)
Additional information
Information and Consent for
Continues on next page
Shooting Activities
Please see the disclaimer overleaf. By completing the consent section of this form you are declaring that the
participant is not restricted by Section 21 of the Firearms Act 1968.
Section 21 of the Firearms Act 1968 prohibits the possession of a firearm and ammunition (under any
circumstances), by any person who has been convicted of a crime and sentenced to a term of imprisonment or
youth custody of 3 months or more. The prohibition applies in all circumstances, including handling and firing
at an approved shooting club or at a clay pigeon shoot where a certificate is not ordinarily required. It also
applies to the possession or use of other categories of firearms and ammunition such as airguns or shot
cartridges for which a certificate is not needed.
© Girlguiding 2014 Information and Consent for Event/Activity 2 of 2
Part II – to be completed by the parent of participants aged under 18.
This form can be returned electronically.
Participant’s full name
Participant’s membership number Age at start of event
Unit name
If your daughter has any health, faith, cultural or dietary needs (including allergies, medication to be
administered etc) that are relevant to this event, please provide details including any additional information her
Leaders may need to know. (If the event involves an overnight stay you will also be given a Health Information
form asking for more detailed information.)
If the event includes water activities, can the participant swim 50 metres? Yes No
NOTE: Please label any medication with your daughter’s name and provide clear instructions for its use. If
applicable, ensure that a spare, clearly labelled inhaler or EpiPen is brought to the event to be held by the first
Emergency contact
Please give details of a person who will be contactable at all times during the event/activity.
Telephone 1 Telephone 2
How do they know the participant?
I give permission for my daughter (named overleaf) to take part in
(event/activity) and for the medication noted here to be administered (if applicable).
The photographic and video permissions you have given in your daughter’s Starting Rainbows/Brownies/
Guides/The Senior Section form will apply at this event/activity.
The only exception to this is at large-scale events (as identified in Part 1) where these permissions do not
apply. At these events it is understood that photographs and videos of your daughter may be taken and used
immediately for event publicity purposes (eg social media). If you do not wish for this to happen please talk
to your daughter’s Leader, who will be able to inform the event organisers.
Parent’s name Date
* Where the terms ‘parent’ and ‘daughter’ are used, they refer to any adult with parental responsibility, and their ward.
I being the parent of the person named below, declare that she is not subject to restriction by virtue of Section
21 of the Firearms Act 1968 (which applies only to persons who have served a term of imprisonment or youth