GAME Enquiry Form

GAME Consent Form

Child's First Name

Child's Surname

Date of Birth

Which site are you enquiring about attending?

Child's Address

Address Line 1

Address Line 2

City

Postcode

Country

What school does the participant attend?

Does your child have any specific medical conditions requiring medical treatment and/or medication?

Yes

If yes please give details:

Does your child have any allergies?

Yes

If yes please give details:

Any other relevant information staff need to be aware of? (However minor it may seem including any emotional or mental health needs)

Parent/Guardian's First Name

Parent/Guardian's Last Name

Parent/Guardian's Phone/Mobile

Parent/Guardian's Email Address

Emergency Contact Details

Name of Emergency Contact

Relationship to child

Contact Number(s)

Name of Emergency Contact

Relationship to child

Contact Number(s)

Has you child attended a Magna Vitae venue or activity before?

Yes

If yes, what activities does or has your child attended with us?

Do you give consent for first aid?

Yes

Do you give consent for your child to leave/travel home unattended? (If no, you are responsible for arranging to meet your child at the GAME session at the venue finish time. If yes, your child will be free to leave the venue when the session has finished.)

Yes

GAME FAQ's (click here to view)

I have read and understood the FAQ's (which can be found above) for the GAME sessions. I understand that booking is not automatic, and I will be contacted to confirm my child's space.

Yes

Photographic Consent

As part of our commitment to children, young people and their families, we require a completed form for every child and young person by gaining parents/guardians permission before we use any images of them in our marketing literature. Your consent indicates that you are happy for us to use your child’s image or quote. Uses could include photos in leaflets, brochures and other written material, videos, CDs, presentations, East Lindsey District Council & Magna Vitae websites and associated pages on public networking sites. No names will be used in any publication.

I give permission for my child to be photographed, filmed and recorded by Magna Vitae Trust for Leisure and Culture, East Lindsey District Council and its partners

Yes

Parental Consent

I give permission for my child to participate

Yes

Signature Parent/Guardian

Print Name

Date

How your information will be used

Magna Vitae is the data controller for the purposes of the GDPR 2018 and the Data Protection Act 2018.

The information provided will be scanned and retained for Magna Vitae’s records only. This will be for as long as necessary to administer your subscription or activities and will be used in the following ways:
• To administer your subscription or activities;
• To validate your Identity and bank account details;
• For fraud prevention;
• For audit and debt collection;
• For statistical analysis.

We may share your information with data validation and credit reference companies to confirm your identity, ensure your bank account details are correct, for fraud prevention and to pursue debtors.

We will not disclose any information to any company other than our partner organisations to help prevent fraud, or if required to do so by law.

Your Rights

The right to be informed;
The right of access;
The right to rectification;
The right to erasure;
The right to restrict processing;
The right to data protability;
The right to object; and
Rights in relation to automated decision making and profiling.

You also have the right to ask us not to process your personal data for marketing purposes. You can exercise your right to allow such processing by checking certain boxes on the forms we use to collect your data. For more information on how long we keep your information or to exercise the above rights at any time, please contact us at info@mvtlc.org.

For a copy of the details that we hold on you, please contact the Data Protection Officer.

You may withdraw consent to contact you at any time by informing the Data Protection Officer at the address below:
Magna Vitae Trust for Leisure and Culture, Meridian Leisure Centre, Wood Lane, Louth, LN11 8SA

We would like to stay in touch with you

From time to time we would like to contact you with information about:

Fitness, gym, attractions and leisure centre activities including swimming, classes and courses

Community activities and sporting/leisure events for all ages

Festivals and events

Shows and entertainment

I do not wish to receive updates

If you, the parent/guardian, agree to being contacted in this way, please tick the relevant boxes:

I do not wish to receive updates

I authorise Magna Vitae to contact me as ticked above

Signature Parent/Guardian

Date

Please fill in the form below to enquire about our GAME sessions.

Emergency Contact Details

GAME FAQ's (click here to view)

Photographic Consent

Parental Consent

How your information will be used

Your Rights

We would like to stay in touch with you

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