© 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
aider.
Emergency contact
Please give details of a person who will be contactable at all times during the event/activity.
Name
Telephone 1 Telephone 2
Address
How do they know the participant?
Consent
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
custody)
