Facilitation and Leadership

2024 YCF Facilitation and Leadership

Step 1 of 8

Consent and information form
Child Safeguarding and Data Protection Statement
Child Safeguarding and Data Protection Statement

To ensure compliance with UK law regarding child safeguarding and data protection, we kindly request your attention to the following guidelines and completion of the provided form. This statement outlines our commitment to maintaining the care and safety of all participants in our events organized by Woodbrooke and BYM.

Legislation and Compliance

Our organization operates in accordance with the relevant UK laws and regulations governing child safeguarding and data protection, including but not limited to the Children Act 1989, the Data Protection Act 2018, and the General Data Protection Regulation (GDPR).

Information and Consent

All participants, regardless of age, are required to complete the Information and Consent form provided. This form serves multiple purposes, including obtaining necessary information for insurance purposes and enabling effective event planning that considers the unique needs of each attendee.

Data Handling and Storage

We handle participant data in accordance with strict data protection protocols. Both electronic and paper forms of data will be collected, handled, and stored securely, ensuring compliance with BYM Policies and applicable data protection laws. Measures are in place to prevent unauthorized access or disclosure.

Parental/Guardian Involvement

If the participant is aged 17 or under, we kindly ask that a parent or guardian complete sections 1-8 of the form on their behalf. Foster carers or individuals with parental responsibility should sign the consent sections and provide their contact details. Please indicate if the participant is a ward of court or a 'looked after child.'

Facilitation and Leadership Partnership

Woodbrooke works in partnership with Quaker Life to ensure the smooth planning and execution of our events. Therefore, we may share your contact information, dietary requirements, meeting or event preferences, and accommodation requests with Woodbrooke to facilitate these arrangements.

Community Agreement and Consequences

All participants must agree to abide by the stated community agreement throughout the event. Any violation of this agreement may result in appropriate consequences, which could include being asked to leave the event. Participants are responsible for the outcomes resulting from any breach of the community agreement.

We understand the importance of child safeguarding and data protection and take these matters seriously. By adhering to these guidelines, we aim to create a safe and inclusive environment for all participants. If you have any questions or require further information, please do not hesitate to contact us.
About the Participant
Age group * REQUIRED
Please state the age bracket of the participant.
(16-18's born after 1.9.2007) Or

(18-21's born after 31.8.2003)
Criteria under which you are completing the form * REQUIRED
If the participant is aged 17 or under the form should be completed by a parent/guardian.
In the case of foster carers, the consent sections should be signed by the person with parental responsibility (you should also provide their contact details in the section about children and young people in care). In such a case you should also indicate when requested if the participant is a ward of court or a 'looked after child'.
1) About the Participant
Participant's legal name * REQUIRED
First Last
Participant's preferred first name * REQUIRED
Please indicate the name the participant would like to be known by at the event.
Participant's Address * REQUIRED
Street Address City County / State / Region ZIP / Postal Code Country
Participant's Phone number (landline)
Participant's Phone number (mobile) * REQUIRED
Participant's email * REQUIRED
One that is checked regularly
Please provide the participants email as this will be used to contact them by mail chimp and for direct email communication.
There is space later on the form to provide your own contact email address. Please ensure that you provide a regularly checked email address for the participant .
This email will be used for communication purposes through MailChimp and direct email correspondence.
You will also find a section later on the form to include your own preferred contact email address.
Participant's Date of Birth * REQUIRED
DD dot MM dot YYYY
Participant's age * REQUIRED
at the start of the Facilitation and Leadership Training (Friday 25 October 2024)
Participant's gender identity * REQUIRED
Please state (this is used for rooming purposes).
Participant's sex * REQUIRED
Please state (this is used for rooming purposes).
Participant's Area Meeting * REQUIRED
Relationship to Area Meeting * REQUIRED
Other, please state * REQUIRED
Is the participant on the JYM Arrangements Committee * REQUIRED
Members of the Arrangements Committee
Support by AVs * REQUIRED
Each young person will be assigned an adult volunteer who will support their planning and preparation in advance of the event. This may include phone calls or email contact. Adult volunteers are asked to copy in a member of staff when communicating with the young person they are supporting
Please indicate below whether you consent to this.
AC commitments * REQUIRED
Please confirm that your child/ward is able to attend all of the planning and preparation meetings (both online and in person), and that you are happy for them to travel independently to the location. This is a requirement for being on the AC - please email cypadmin@quaker.org.uk if this is not the case!
The dates are (some of these are TBC as outlined in the introductory email):
- monthly evening Zoom meetings, first Thursday of each month (aside from 9 Jan)
- 13-15 Sep in London
- 22-24 Nov (location TBC)
- 7-9 Feb (location TBC)
- EITHER 28-30 Mar OR 4-6 April (TBC - please keep both dates free and we will confirm ASAP)
- JYM 2025 - 23-26 May, Frontier Centre, Northamptonshire (prep day 22 May if possible but not a requirement; coaches provided from train station)
All AC weekends will start on Friday evening - if participants need a letter to enable them to leave school early we can provide this.
- Yes - they can attend all dates and travel independently
- No - I will contact you with more information

3) Emergency contacts
This information enables us to contact those who need informing in the event of an emergency.

Please provide contact details for two individuals
The first person should be the person who has parental responsibility or guardianship of the participant.
The second person should - where possible - be at an alternative address to the first contact.
First emergency contact * REQUIRED
If under 18 at the time of the event this should be the person with parental responsibility or guardianship of the participant.
First Last
First emergency contact: Relationship to the participant * REQUIRED
Please state your emergency contacts relationship to you
Children and young people in care
If the participant is a 'looked after child' or 'ward of court' please tick the relevant boxes.
- Looked after child
- Ward of court
In care details * REQUIRED
If the participant is a 'looked after child' or 'ward of court' please provide relevant details.
First emergency contact: Address during the event * REQUIRED
Street Address City Region Post code Country
First emergency contact: Phone number (landline)
First emergency contact: Phone number (mobile) * REQUIRED
First emergency contact: Email (one that is checked regularly) * REQUIRED
Secondary emergency contact * REQUIRED
We require a second emergency contact in the event that we are unable to make contact with the person with parental responsibility.
It is preferable that this person is a a different address to the Emergency contact stated above.
First Last
Secondary emergency contact: Relationship to the participant * REQUIRED
Secondary emergency contact: Address during the event * REQUIRED
Street Address City Region Postcode Country
Secondary emergency contact: Phone number (landline)
Secondary emergency contact: Phone number (mobile) * REQUIRED

4) Participant needs
This helps us plan for or be aware of any needs the participant may have and how this might affect the support we provide and our facilitation at the event. You may find it helpful to read the following:
Why we ask about participant needs explains why we ask for this information.
With health condition this means that if the participant is taken ill we have the appropriate information to hand to health care professionals.
Asthma * REQUIRED
Asthma emergency * REQUIRED
Please state what signs and symptoms indicate an asthma attack. Please also include any information that we might need to know (for example admitted to hospital in the last year for asthma, the type of inhalers they use) IMPORTANT! If the participant uses a SMART or MART medicine regimes, please provide information on action to take in an emergency.
a) Allergies (including anaphylaxis) * REQUIRED
e.g. dietary, medication, chemical, environmental etc
a) Allergies emergency * REQUIRED
If relevant, please detail actions to take in an emergency (in relation to allergies)
In the event of a medical emergency:
Please describe what signs or symptoms indicate an emergency for the participant.
Please detail the action to be taken in the event of an emergency,
• if and how medication should be administered and the amount
• any special precautions in relation to the medication that should be taken, e.g. signs that medication should not be given, any side effects that we need to know about
• the procedures we should take in an emergency
• include anything medical professionals need to know
• besides yourself, who should be notified, e.g. specialists, GP.
a) Allergies detail * REQUIRED
.Please give further details to enable us to appropriately support the participant. .
• explain how it affects the participant (e.g. regularity, impact).
• if they have needed emergency treatment or have been admitted to hospital in the last year.
• if relevant how it can be avoided, prevented or minimised.
• detail any action we may need to take for example if there are any support needs (in the box below please detail how we should respond in an emergency).
• if relevant give the contact details for medical professionals or social worker.
b) Cognition and learning needs * REQUIRED
(e.g. Dyslexia, ADHD, Dyspraxia etc)
b) Cognition and learning needs detail * REQUIRED
Please give further details to enable us to appropriately support the participant.
• what are the characteristics of their need
• what type of situations do they find particularly difficult?
• what might indicate that they are struggling or finding something challenging?
• what strategies help them to manage their need?
• are there any adjustments that would further their participation?
• to what extent does their need impact on their life i.e. do they have additional support provided e.g. extra help in school, specialist support, a statement of SEN, an EHC plan (what does this recommend)? What support do they require to further participation?
• if relevant and appropriate give the contact details for supporting professionals
c) Communication and interaction needs * REQUIRED
(e.g. Autistic spectrum disorder, support from a speech and language therapist, hearing impairment etc)
c) Communication and interaction needs detail * REQUIRED
Please give further details to enable us to appropriately support the participant.
• what are the characteristics of their need
• what type of situations do they find particularly difficult?
• what might indicate that they are struggling or finding something challenging?
• what strategies help them to manage their need?
• are there any adjustments that would further their participation?
• to what extent does their need impact on their life i.e. do they have additional support provided e.g. extra help in school, specialist support, a statement of SEN, an EHC plan (what does this recommend)?
• what support do they require to further participation?
• if relevant and appropriate give the contact details for supporting professionals
d) Mental health conditions * REQUIRED
(e.g. panic attacks, depression, self harm, disordered eating etc)
d) Mental health conditions detail * REQUIRED
Please give further details to enable us to appropriately support the participant.
• what are the characteristics of their need
• what type of situations do they find particularly difficult?
• what might indicate that they are struggling or finding something challenging?
• what strategies help them to manage their need?
• are there any adjustments that would further their participation?
• to what extent does their need impact on their life (how regularly does it have an impact, what impact does it have)?
• if relevant and appropriate give the contact details for supporting professionals
e) Physical health conditions * REQUIRED
(e.g. Asthma, Diabetes, Epilepsy, Migraine etc)
e) Physical health conditions emergency * REQUIRED
If relevant, please detail actions to take in an emergency (in relation to physical health conditions)
Please describe what signs or symptoms indicate an emergency for the participant.
Please detail the action to be taken in the event of an emergency,
• if and how medication should be administered and the amount
• any special precautions in relation to the medication that should be taken, e.g. signs that medication should not be given, any side effects that we need to know about
• the procedures we should take in an emergency
• include anything medical professionals need to know
• besides yourself, who should be notified, e.g. specialists, GP.
e) Physical health conditions detail * REQUIRED
Please give further details to enable us to appropriately support the participant.
• explain how it affects the participant (e.g. regularity, impact,)
• if they have needed emergency treatment or have been admitted to hospital in the last year
• if relevant how it can be avoided, prevented or minimised
• detail any action we may need to take (how we should respond in an emergency, and if there are any support needs)
• if relevant give the contact details for medical professionals or social worker
f) Sensory and physical needs * REQUIRED
(e.g. impaired hearing or sight, colour blindness, restricted mobility etc)
f) Sensory and physical needs * REQUIRED
Please give further details to enable us to appropriately support the participant.
• what are the characteristics of their need
• are there particular situations that they find particularly difficult?
• what might indicate that they are struggling or finding something challenging?
• what strategies help them to manage their need?
• are there any adjustments that would further their participation?
• to what extent does their need impact on their life (e.g. what impact does it have)?
• if relevant and appropriate give the contact details for supporting professionals
g) Social and/or emotional wellbeing * REQUIRED
e.g. young carer, third culture individual, low self esteem, or anything else we should be aware of to ensure the participant has appropriate support at the event
g) Social and/or emotional wellbeing detail * REQUIRED
Please give further details to enable us to appropriately support the participant.
• what are the characteristics of their need
• what type of situations do they find particularly difficult?
• what might indicate that they are struggling or finding something challenging?
• what strategies help them to manage their need?
• are there any adjustments that would further their participation?
• to what extent does their need impact on their life (how regularly does it have an impact, what impact does it have)?
• if relevant and appropriate give the contact details for supporting professionals
h) Medical treatment * REQUIRED
Does any of the above (a-g) require medical treatment
h) Information about medication * REQUIRED
If relevant please include the following information about the medication:
• the medication required and the condition it is for
• the amount taken and how the medication is taken e.g. tablets, inhaler, injection
• when the medication is taken (times of day, in an emergency)
• whether the participant can self medicate
• any side effects resulting from the medication that we need to know about
• any storage requirements for this medication (e.g. refrigeration, secure for a controlled drug). Please ensure that medication is sufficient and is clearly and correctly labelled, i.e. that it is in the correct container, with participant’s details, and indicates the dose taken each day.
h) Medication in an emergency * REQUIRED
The participant can be administered their medication by an adult team member in an emergency.
i) Able to participate * REQUIRED
I consider the participant to be medically and psychologically fit to participate in this event.
- Yes

5) Medical information
It is your responsibility to notify us, in advance of the event, of any changes in the medical information or medical treatment detailed on the enclosed form.
Any updates should be written, signed and sent to the CYP administrator at (cypadmin@quaker.org.uk).
You must also contact us if the participant is exposed to, or suffers from any infectious disease in the 4 weeks prior to the event. Informing us of this will not necessarily preclude them from attending the event. Decisions would be made on a case by case basis and in light of any vulnerable participants or team members who may be adversely affected by the infection.
Name of Surgery
Name of GP
First Last
Surgery Phone Number * REQUIRED
Surgery Address * REQUIRED
Street Address City Region Postcode Country
Date of last anti-tetanus injection

Day
Month
Year
Medical permissions
Pain/Flu relief - the provision of pain/flu relief is not a service Britain Yearly Meeting events are obliged to undertake. We recognise that whist at events, participants can become unwell so ask that you indicate your consent or otherwise to pain/flu relief medication that may be given.
Ibuprofen * REQUIRED
Paracetamol * REQUIRED
Flu relief * REQUIRED
Plasters * REQUIRED
Plasters detail
Please provide detail (e.g. no plasters, no waterproof plasters, no latex, micropore ok etc)
Sting relief * REQUIRED
In the event of an emergency or accident.
Should your child/ward become ill or have an accident, every effort will be made to contact you as soon as possible.
In the event of an emergency or accident we will call the emergency services first. Healthcare professionals may give treatment immediately when it is in the young person's best interests.
For your child/ward to attend the event, you need to give the following permission:
Emergency treatment
I give permission for any treatment deemed necessary and in the young person's best interests to be given by healthcare professionals. For your child/ward to be able to attend the event you must give permission.
- Yes

6) Data protection
Use of data
In accordance with the Data Protection permission must be granted by the parent/guardians or participant (if over 18) before any images may be taken and used, and for how the personal data can be used.
Britain Yearly Meeting uses images of Quakers to attract new members. Good images also encourage people to take part in our activities.
We need you to indicate whether you give your consent for images of the participant to be used in printed materials and on our website, social media channels and for 11-18's in videos. We will not identify them by name or local meeting, some materials may be created with partnership organisations.
Image consent * REQUIRED
Do you actively consent to the the participant's image being used under the above conditions?
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk
Please upload a picture of the participant * REQUIRED
We need a record of what the participant looks like, this enables us to delete any images taken of them during the event.
Max. file size: 2 MB.
Data consent * REQUIRED
Do you actively consent to the contact information you have provided being used to send promotional information about future events and opportunities?
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk
Data consent Woodbrooke * REQUIRED
Do you actively consent to the contact information you have provided being used to send promotional information about future Woodbrooke events and opportunities?
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk
Online communications
We use social media and mail chimp to communicate with young people about the event and ways they can be involved in opportunities within Quakerism and young people's organisations:
Mailchimp * REQUIRED
Do you actively consent to our using the above data to make contact using mailchimp?
In agreeing to this you acknowledge that the information you provide will be transferred to MailChimp for processing in accordance with their privacy policy and terms.
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk
Social Media * REQUIRED
Do you actively consent to us contacting the participant using BYM social media accounts: Facebook, Instagram and Twitter
We will only contact children over the age of 13 using social media.
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk
Should you wish to withdraw your consent at any time, please contact: cypadmin@quaker.org.uk

Payment details * REQUIRED
Please indicate who will be paying for the place
- I am paying for my place
- My meeting/event is paying for my place
- I am on the JYM Arrangements Committee
- I have applied for a bursary
Payment method
We will provide an invoice to pay for the event. Please provide contact details for the person who should receive this (e.g. parent, Area Meeting treasurer).
Invoice contact
First Last
Invoice address
Street Address Address Line 2 City Region Post code Country
Invoice email
Please give the email address for the invoice
Enter Email Confirm Email

Confidentiality and community agreement
The participant's place is conditional on their consent to this.
All participants who attend need to agree to abide by the community agreement, and accept responsibility for the consequences of any breaking the community agreement (which may include being asked to leave the event). Any place at an event will be conditional on the participant completing the community agreement.
Confidentiality and community agreement * REQUIRED

The participant's place is conditional on their consent to this.
All participants who attend need to agree to abide by the community agreement, and accept responsibility for the consequences of any breaking the community agreement (which may include being asked to leave the event). Any place at an event will be conditional on the participant completing the community agreement.
- I Understand and agree to complete the Community Agreement
Event consents
Please read points and indicate your consent below:
- I give permission for the named participant to take part in this event.
- I understand that there will be consequences if the participant breaks event boundaries – the most serious of which is to be asked to leave the event (if this happened the person with parental responsibility would be contacted).
- I understand that if my child/ward has particular needs and I haven’t included this information on the form, or subsequently informed the staff in writing and this has a detrimental impact on the programme or other participants, Britain Yearly Meeting may have to withdraw them from the programme.
- I understand that the Children Act (2004) requires that if a team member is concerned about the safety of a participant (or the safety of someone known to them) they are required to inform the event’s Safeguarding Coordinator.
- I understand where relevant the information on this form will be shared with the venue, and if necessary with healthcare professionals.
Signature and event consents * REQUIRED
To be completed by the parent/ over 18 participant/ or legal guardian or social worker.
I have read the guidance and information on this form and have completed all relevant sections accurately and in full. I give my consent to the statements and requirements on this form and for the named participant to attend as stated. If you would like any further information or have any questions about any part of this form please contact
Paul Tilley on 07958009744.
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QForms YCF

Online forms and surveys from quaker.org.uk

Facilitation and Leadership

2024 YCF Facilitation and Leadership

Step 1 of 8

Consent and information form

Child Safeguarding and Data Protection Statement

Legislation and Compliance

Information and Consent

Data Handling and Storage

Parental/Guardian Involvement

Facilitation and Leadership Partnership

Community Agreement and Consequences

About the Participant

1) About the Participant

Members of the Arrangements Committee

2) Participant's dietary information

3) Emergency contacts

4) Participant needs

5) Medical information

Medical permissions

In the event of an emergency or accident.

6) Data protection

Use of data

Online communications

Payment method

Confidentiality and community agreement