School Immersion Programme Application & Consent

Parental Consent

This section MUST be completed a parent or guardian.
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Participant Details

Student Name*

Student School*

Parental Permissions & Support (please click each one)

Permission for Participation*

I have read all the information provided concerning the HOPE Schools Immersion Programme. I hereby give permission for the above named student to participate in the above activity which includes fundraising and participation in a visit to Kolkata, India to view HOPE’s projects.

Permission for Medical Care*

In the event of the above named student being taken ill or injured during his/her time with the group, should any surgical operation or injection become urgently necessary, I hereby authorise the adult group leader in charge to sign any written forms or consent required on my behalf.

Independent Travel Insurance*

I understand that it is a condition of the Immersion Programme that I must ensure the above name student has independent travel insurance. This insurance must include travel, medical expenses and repatriation as standard, and must allow for a child under the age of 18 to travel without a parent/guardian.

Permission for Programme Communications*

Immersion Programme participants may be contacted directly by group leaders and/or by HOPE by text, email, or phone regarding group activities, fundraising and travel arrangements. I consent to the above named student being contacted in this respect. (All contact details will be confidential).

Permission for Use of Images and Media*

I consent to the use of images and video of the above named student taken during activities related to the Immersion Programme to be used in HOPE media. (These media will not be used in any other context or shared with any third party.)

Parental Support*

I agree to support the above named student in all aspects of the HOPE Immersion Programme, including fundraising. I understand the fundraising target must be met in order for my son/daughter/other to travel. I agree to read all literature provided in relation to this programme and to familiarise myself with all guidelines provided by HOPE and the group leader(s) in relation to this programme.

I would like to receive updates on the work and activities of HOPE (optional).

Signature

Name*

Relationship*

Sign below*

Clear

Signature*

This field should be left blank

School Immersion Programme Application & Consent

Personal Information

School Information

Next of Kin Information

Medical & Dietary Information

Parental Consent

Participant Details

Parental Permissions & Support (please click each one)

Signature

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