Consent Form 1Contact Details2COVID-193Consent Parent's DetailsParent's Name(Required) First Last Email(Required) Mobile Contact Number(Required)Home Contact Number(Required)Child's DetailsChild's Name(Required) First Last Date of Birth(Required) Day Month Year Child’s Medical Details: (Diagnoses/ health conditions/ allergies etc.) This field is hidden when viewing the formCOVID-19 Procedure Please ensure you inform us if your child or anyone in their household has COVID-19 symptoms (continuous cough, fever, loss of taste etc.) and/or positive test results to keep Track and Trace records up to date. DO NOT attend sessions if you or anyone in your child’s household has been unwell - we will be able to reschedule your session! Records of attendance will be kept and you will be contacted in the event of a COVID-19 trace. Please read the following and sign below: Only one person should accompany your child to their session. This is to minimise the number of people inside the building at one time. Anyone entering the sensory room will have their temperature taken with an infrared wand.Please keep to allocated times as late arrivals will result in a shorter session in the sensory room.Please wash your hands before and after sessions. You may bring your own small towel.Hand sanitiser will be offered though not necessary to use as not all children like the smell or texture.If you are a wheelchair user please use the lift, if not please enter the sensory room via the stairs at present.Please wait outside the front door until we come down to let you in. This is again to reduce the number of people inside the building and to ensure the room has been adequately cleaned before your child’s session.All equipment used in the sensory room will be cleaned after each session and an inspection of the cleaning rota can be requested.We will wear a mask or shield in the room and social distancing will be maintained where possible. Parents and children are not required to wear a mask/shield but can do so if they wish. Consent(Required) I confirm that I have read the COVID-19 Procedure above. This field is hidden when viewing the formConsentI give permission for Sensory Kids: To share comments I make about this service on social media/advertising (names will not be used).I give permission for Sensory Kids: To share pictures and videos of my child taking part in activities during sessions on social media/advertising (names will never be associated with images/videos).I understand that:(Required) I agree to the terms and conditions as listed below:A parent or guardian should attend the sessions or wait outside the sensory room. The adult bringing the child to sessions must be contactable for the duration of the session. I must be punctual on arrival and I accept that if I am late the time will have to be deducted from the session. I may cancel my child’s session up to 12 hours before it is scheduled to take place. I will give at least 12 hours notice if I need to cancel, otherwise, I will be charged for the session in full. I can contact Sensory Kids via Facebook, Instagram, email or phone and my query will be responded to as soon as possible. I acknowledge that staff/volunteers will be unable to respond to my calls/messages when sessions are ongoing.Signature(Required)Date(Required) DD slash MM slash YYYY CAPTCHA
