RSVP 1 — My Time For Young Carers

PERMISSION FORMS

If you would like your child to join us, please fill in the 3 forms below (or if you are a young carer yourself, ask for your parents or guardian’s help and permission) and we will get back to you as fast as we can. They wont take as long as you think to fill in!

MEMBERSHIP FORM

Name

First Name

Last Name

Address (including postcode)

Date of Birth

Parent/Guardian Name

First Name

Last Name

Phone/Mobile

Emergency Second Contact Name

First Name

Last Name

Emergency 2nd Contact Phone/Mobile

Medical Needs

THIS INFORMATION IS GIVEN IN CONFIDENCE TO ENSURE THE MEDICAL NEEDS OF YOUR CHILD ARE MET. IT IS YOUR RESPONSIBILITY TO UPDATE US IF THIS CHANGES IN ANY WAY. If your child has any health, allergies or dietary needs please detail:

Treatment Plan

What is the treatment plan for your child, please detail:

Medication

Please detail medication that will be brought to club and events which you are happy for your child to self- administer (NAME, DOSAGE, DIRECTIONS OF USE):

Brief Details of Caring Role

Current Height of Child (in metric)

Do you have a booster seat?

I would like my child to become a Member of My Time and confirm I have read the terms of the volunteer driver scheme and give permission for my child (named at the top of this form) be driven to and from club and events by a volunteer driver if required. It is important to note that the legal requirement for children travelling by car is that they should use a booster seat until they are either 135 cm – approx. 4ft 5ins in height or 12 years old (whichever they reach first). Please confirm you understand this regulation, as the drivers will expect them to use the booster seat if necessary. Signed:

Date

VOLUNTEER DRIVER SCHEME FORM

My Time for Young Carers recruits volunteers to assist with transporting its members to clubs and holiday activities. Volunteers use their own cars and are invited to claim for the reimbursement of petrol costs. To ensure the safety of My Time members the following terms for the volunteer scheme are in place:

· Drivers must be over 21 years

· Have a clean driving licence

· Supply annually details of their car insurance and MOT.

· Have an Enhanced DBS check (police check)

· Provide two referees for reference checks.

· Wear their volunteer ID card.

· Have emergency contact details of members they are transporting.

· Only transport members in the rear of their car.

· Comply with all legal requirements:

i. Use a booster seat where necessary.

ii. Do not use mobile phones or other devices whilst driving.

iii. Do not smoke whilst driving.

· Pull over should they feel unwell or if a member is behaving poorly and causing a distraction.

· Confirm they do not have any medical conditions that would negatively impact on their ability to drive.

· Sign a My Time Staff and Volunteer Commitment statement.

Name

First Name

Last Name

I understand the terms of the volunteer driver scheme and am for my child to use the service. I have explained to my child the importance of behaving well whilst using a volunteer’s car. Signed:

Date

MEMBERS GDPR PERMISSIONS

The information that you have given us will be treated in the utmost confidence and stored in accordance with GDPR guidelines. Information that you provide in a membership, registration or enquiry form is subsequently stored on a secure server. We also take appropriate measures to ensure that the information we receive is kept secure, accurate and up to date via review processes and kept only for so long as is necessary for the purposes for which it is used. All access to our secure server is restricted only to authorised staff and trustees where required.

View our full privacy policy

Name

First Name

Last Name

We would welcome your consent to take and use pictures of your child during sessions or holiday activities for My Time publicity leaflets, our website or on social media such as Facebook, Instagram or Twitter. We guarantee never to name your child

Signature

To ensure the welfare of our members, it is important that some leaders or volunteers have personal, including sensitive information available when My Time members are away from home. Please sign if you are happy for us to share this information to Session Leaders, drivers and /or nominated My Time volunteers who will be accompanying your child. We do not share personal information with 3rd parties without consultation with you, unless we believe a child is an immediate welfare concern

Signature

Please confirm you are happy to be contacted via the following methods:

Telephone

Text

Post

Signature

Date

PERMISSION FORMS

MEMBERSHIP FORM

VOLUNTEER DRIVER SCHEME FORM

MEMBERS GDPR PERMISSIONS

My Time for Young Carers

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