This form records the informed consent of the participant (and, for under-18s, their parent or guardian) to take part in the Programme and to the specified processing of their information.
Participant Details
| Field | Detail |
|---|---|
| Full name | |
| Date of birth | |
| Address | |
| Email / phone | |
| Emergency contact | |
| Relevant medical / accessibility needs |
1. Consent to Participate
I confirm that I (or my child) wish to take part in the Programme delivered by Bernardine Ltd, and that I have read and understood the Participant Agreement, Terms & Conditions, and Disclaimer.
2. Consent to Data Processing
I consent to Bernardine Ltd collecting and processing the information on this form for the purposes set out in the Privacy Policy, including administration, progress tracking, and safeguarding.
Tick to confirm each:
- ☐ I consent to the processing of personal data for delivery of the Programme. (Required)
- ☐ I consent to the processing of health/accessibility data for my safety. (If applicable)
- ☐ I consent to outcome data being shared, in anonymised form where possible, with a referring/funding council. (Pilot only)
- ☐ I consent to receive optional updates and marketing. (Optional)
3. Media Consent
- ☐ I consent to photographs/recordings being taken during the Programme and used for promotional purposes.
- ☐ I do not consent to use of my (or my child's) image.
Media consent is optional and can be withdrawn at any time by contacting jmalhotra@bernardine.co.uk.
4. Parental / Guardian Consent (participants under 18)
I confirm that I am the parent/legal guardian of the named participant, that I have authority to give this consent, and that the emergency and medical information provided is accurate.