*Cancelled - Friday 3 May, Tots Session and Wednesday 8 May, Messy Play Session at Stewarton Area Centre.
*Community libraries will be closed on Saturday 4 May for the bank holiday weekend - Burns House Museum & Library and Dick Institute will remain open. *Mobile libraries will not be in service on Monday 6 May.
*Cumnock Library will be closed from 1.15pm to 3pm on 7 May.
We apologise for any inconvenience.

Activity/Event Parental Consent Form

Prior to your child attending an event or activity you will need to complete the consent form below. if you prefer you can print off a copy of the form and return it to the venue

The information you have supplied above will be used solely for the registration of your child in the specific event you have detailed. We require this information to register your child and to ensure the safety of your child and other children at the event. Without this information we are unable to allow your child to participate in the event. The information will be processed and held securely in terms of Data Protection Legislation. For further information on our legal basis for processing your information and your rights in terms of Data Protection Legislation you can view our Privacy Statement here

Name of Event/Activity

Date of Event/Activity

Participant Details

Parent / Guardian Full Name

Name of Participant

Gender

Male

Female

Address

Postcode

Date of Birth

Contact Details for First Point of Contact

Name

Relationship to Child

Address

Contact Telephone Number

Email Address

Emergency Contact Details

Name

Relationship to Child

Address

Contact Telephone Number

Doctor's Contact Details & Medical Information

Name/Surgery

Telephone Number

Does your child have any illnesses, disabilities or allergies that may affect them when taking part in the activity/event? If yes, please provide further details to ensure that we have the appropriate measures in place.

Does your child require the routine use of any medication or are they currently receiving any medication? If yes, please provide further details.*Please note that any medication will need to be self - administered.

I give permission for my child to receive first aid or CPR in the event of an emergency or accident

Does your child have any special dietary requirements? If yes, please provide further details.

Activity/Event Parental Consent Form

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