Parental Consent Form – Worksop Ladies Hockey Club

WLHC Junior Member Parental Consent Form

This consent form applies to:

WORKSOP LADIES HOCKEY CLUB

For the season:

2017-2018

Name of Junior Player: ……………………………………………………………………………………………………………..

Name of parent/guardian completing the form: ………………………………………………………………………………

I acknowledge receipt of the England Hockey Safeguarding Good Practice Policy and the WLHC amendments, additions and clarifications document that together form the WLHC Safeguarding Policy. I have read and understand the policies in place and will do everything possible to adhere to them.

Signed…………………………………………………. Parent/Guardian Date ………………………….

Signed…………………………………………………. Junior Member Date…………………………..

Please delete as required to agree or disagree to the following areas in relation to your child participating and being an active member of the club. Please add your child’s name where a blank gap is left to indicate it.

Photography

I do / do not give consent to WLHC to take photographic or recorded images of ………………………………………………………….

I do / do not give consent for WLHC to agree to other teams taking photos of their team that may include images of my child

I do / do not give consent for WLHC to include images of my child on the closed WLHC Facebook group.

I do / do not give consent for WLHC to provide images/have images taken of my child to the Worksop Guardian for match reports that will appear in the local paper.

I confirm / do not confirm that there are no legal restrictions related to taking photographic images.

Signed ……………………………………………….. Parent/Guardian Date …………………………

I am / am not happy for photographs to be taken of me whilst at hockey.

Signed …………………………………………………. Junior Member Date ……………………….

Match Reports

I do /do not give consent to WLHC to include ………………………………………………………….(s) name in team match reports that will be posted on the clubs website and printed in the Worksop Guardian

Signed ……………………………………………….. Parent/Guardian Date …………………………

I am / am not happy for my name to be included in match reports

Signed …………………………………………………. Junior Member Date ……………………….

Transportation

Guidelines state that wherever possible a junior member’s parent or guardian transports them to and from any hockey event including training and matches however we appreciate that this isn’t always possible. If you are happy for the club to help out in the transportation to and from hockey events then please give your consent below.

I do / do not give consent to WLHC members transporting ……………………………………………… to and from away matches in accordance with the clubs transportation policy as laid out in the Safeguarding policy.

I do / do not give consent to WLHC members transporting ……………………………………………… to and from training in accordance with the clubs transportation policy as laid out in the Safeguarding policy.

I do / do not give consent to WLHC members transporting ……………………………………………… to and from club events in accordance with the clubs transportation policy as laid out in the Safeguarding policy.

Signed ……………………………………………….. Parent/Guardian Date …………………………

I am / am not happy to be transported by another adult member of the club to and from hockey events and understand I should never be in a car alone with another adult member

Signed …………………………………………………. Junior Member Date ……………………….

Changing Rooms

I do / do not give consent for ……………………………………………… to get changed in the changing rooms whilst adult members of the club are in there at the same time.

I do / do not give consent for ……………………………………………. to be in in the changing rooms at the same time whilst adult members are getting changed.

Signed ……………………………………………….. Parent/Guardian Date …………………………

I am / am not happy to be in the changing room whilst other adult members are getting changed.

I am / am not happy for other adult members to be in the changing room whilst I am getting changed.

Signed …………………………………………………. Junior Member Date ……………………….

Social Media

I am / am not happy for ………………………………….. Facebook account to be a member of the closed WLHC group and / or team closed groups on Facebook.

By giving this consent I am happy for ………………………………………… to be in contact with other adult club members on Facebook through the above-mentioned groups with the understanding that all adult members have been made aware of their responsibility to only post or share content appropriate to anyone who could see it on their profile. This is relevant whether the post is related to hockey or directed specifically to a WLHC member directly or not.

I am aware that WLHC strongly discourages the acceptance of junior members on personal Facebook and other social media accounts if the main reason for their contact is through the hockey club, however the club cannot enforce or monitor this on an individual basis.

Signed ……………………………………………….. Parent/Guardian Date …………………………

If you have any concerns or questions relating to any information on this consent form or any of WLHC policies then please do not hesitate to contact a club committee member.

If you have had or ever have any concerns in relation to the welfare of your child, another junior club member or any concern relating to safeguarding and welfare in the club then please feel free to speak with the clubs welfare officer:

Club Welfare Officer Details:

Name: Jemma Robbins

Mobile Number: 07742 953 683

Email: [email protected]

These details are correct for the 2017-2018 season.

All polices and contact information for the committee and welfare officer is available on our website at