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Young Flintshire Consent Form 2024/25

1Your Details 2Enquiry Details

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Your Details

Forename

Surname

Phone Number

Email Address

Address

Recently Used Address

Address

If you are using a screen reader, do not fill in this field If you are using a screen reader, do not fill in this field

Enquiry Details

Young Person Details

Forename

Surname

Date of Birth

Gender

Male Female

What is the Young Person's ethnic group? Choose one option that best describes their ethnic group or background.

White Gypsy or Irish Traveller Mixed – White / Black Caribbean Mixed - White / Asian Mixed - any other background Black - Caribbean Black - African Black - any other background Asian - Indian Asian - Bangladeshi Asian - Pakistani Asian – Chinese Asian – other Other Prefer not to say

Which Flintshire School does the Young Person currently attend?

Which Flintshire School does the Young Person currently attend?

Details of Other Location

Which year group is the Young Person currently in?

Is the Young Person acting as

Contact Information

Email Address (This is the email address for preferred young person contact – it could be a Young Person email address or the parent/carer email address)

Young Person's Contact telephone number

Address Line 2:

Address Line 3:

Address Line 4:

Address Line 5:

Post Code:

Young Person Declaration

I am willing for you to use the details on this form to provide me with Young Flintshire information and communicate with me on Young Flintshire events and opportunities

Young Person Name

Date

Parent / Carer Consent

Medical and Dietary

Please give details of any physical or psychological condition your child has that may affect him/her during Young Flintshire meetings and events

Please give details of any allergies

Please give details of any dietary requirements

Please give detals of any recent illness

Please give details of medication

Date of Last Tetanus injection

Photo Consent

To comply with the Data Protection Act 2018 we need your permission before we can photograph your child. Please answer the questions below and sign and date the form where shown.

May we use your child's photograph in Young Flintshire Newsletters (visible publicly via the council website)?

Yes No

May we use your child’s image on the council website or other electronic communications visible publicly?

Yes No

Are you happy for your child to appear in the media e.g. if a newspaper photographer attends an event organised by the council?

Yes No

The Authority will accept only the pupil’s home address and not that, for example, of child minder or grandparents. Proof of address may be required. Parents are advised that a school place may be lawfully withdrawn if the information given on their application form is fraudulent or misleading.

Parent / Carer Contact Details

Home Telephone No.

Work Telephone No.

Telephone / Mobile No.

info_1

Home Address

Is the child's permanent home address different from yours?

Yes No

Child's permanent home address:

Address:

Alternative Emergency Contact

Name

Telephone

Address

Family Doctor

Name

Telephone

Address

Parent / Carer Declaration

Having read the information about Young Flintshire, and having understood the level of supervision provided, I agree to my child taking part in Young Flintshire and activities including face to face and online platform events

I understand that all reasonable care will be taken of my child during Young Flintshire activities

I understand that if my child seriously misbehaves or is a cause of danger to him/herself or to others then I may be asked to collect him/her

Full Name of Parent / Carer

Signed

Date

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Privacy Policy

Privacy Policy

Flintshire County Council Young Flintshire Privacy Notice

This privacy notice is designed to inform you about how we collect, use, share, and protect your personal information during any participation with Young Flintshire provision within Flintshire. Please read this notice carefully to understand our practices.

What personal information do we collect?

Full name
Date of birth
Gender
Ethnicity
Contact Information (address, email, phone number)
Emergency Contact Information
Medical Information (allergies, medical conditions, disabilities)

What we do with your personal data and for what purpose?

Your data will be processed by Flintshire County Council as part of our public task for the specific purposes as a local authorities’ duty to secure services and activities for young people aged 12 to 18, to improve their well-being, as defined in Subsection 13 under Section 507B of the Education Act 1996 and as a local authorities duty to support National Standards for Participation to reflect the rights based ethos that is integral to working with children and young people. The National Participation Standards are a guide on the best and most meaningful ways of listening and responding to the voices of children and young people, in line with Article 12 of the UNCRC. Article 12 of the UNCRC sets out the right of children and young people to express an opinion and to have their opinion taken into account when decisions are being made on any matter that affects them. This Article is seen as particularly important, in that it is an enabling right, empowering and supporting children and young people to access broader rights under the UNCRC, within the family, the school and the larger community context.

The data that Healthy Schools collects is to ensure we can provide the best service to you and protect you whilst participating in our activities. Your information is used for the purposes of:

Registering you on our client system to record your participation at our sessions.
Protecting your and others’ safety and wellbeing when attending our sessions.
Communicating and sharing information about other young voice activities that may interest you.
Complying with legal, regulatory, and reporting requirements.

Special categories of personal data

Your special category data (medical, health and ethnicity) will be processed by Flintshire County Council under Article 9; (g) processing is necessary for reasons of substantial public interest under paragraph (6) ‘Statutory and Government Purposes’ under schedule 1 of the Data Protection Act 2018. Refer to the above acts.

When will we destroy or delete your data?

Our service delivers to young people between 12 and 18 years of age. Your information will be deleted 6 months after you last attend/participate in any activity with Young Flintshire.

Would my data be shared with any other parties?

Your data will only be shared with other council departments on projects that arise through Young Flintshire agendas, along with other services, such as Social Services, North Wales Police, or a health professional if an incident occurs or information is disclosed that may pose a safeguarding risk to you or another person. This is a Flintshire County Council requirement under the UK Children Act 2004 to improve the safeguarding of children and young people.

If you feel that Flintshire County Council has mishandled your personal data at any time you can make a complaint to the Information Commissioner's Office by visiting their website or by calling their helpline on 0303 123 1113.

For further information about how Flintshire County Council processes personal data and your rights please see our privacy notice on our website

http://www.flintshire.gov.uk/en/Resident/Contact-Us/Privacy-Notice.aspx