Parental Consent Form

Terminology

We will be refering to CC as Country-Cousins. "We" is refering to Country-Cousins as an organization.

MEDICAL CONSENT

Medical Consent*

I consent to seek Medical Care for my child as necessary when my child is in CC' staff care.

I agree to the organization (CC) staff giving the Student common, non-prescribed medicine, i.e. paracetamol, cough syrup, ibuprophen in case of sickness.
I agree to CC staff giving the Student controlled medicines prescribed by a doctor in the Student's country or in England.
I give permission for CC staff, in an emergency, to follow the advice of attending medical staff and to authorise medical treatment and/or anaesthetic for the welfare of my child.

PUBLICITY

We take photographs and videos of individuals and groups of students for use in its publicity material and in social media (Facebook and Instagram mainly). Please tick the boxes below if you are willing for the Student to be included in such group photographs/videos.

I consent to photographs being taken of my son/daughter and used in publicity materials, either individually or as part of a group*

Yes
No

I consent to videos being taken of my son/daughter and used in publicity materials, either individually or as part of a group*

Yes
No

I consent to photos/videos being taken of my son/daughter and used on social media platforms, such as Instagram and Facebook*

Yes
No

TRAVEL

Students will be met and collected from the airport/train station by trained CC ‘Meet & Greet personnel’ who will be waiting at the Arrivals hall. The student will be accompanied by CC staff to Ilfracombe Devon to begin the course.

I agree for the care arrangements for my child’s travel to, reception and care while in the United Kingdom and confirm that my child has my consent to live and travel independently*

Yes
No

ADDITIONAL FREEDOM

CC has curfew times according to the age of students. Students are supervised during the day whilst in lessons and on activities. There are times where the students have additional freedom, for example walking to/from school -home, or meeting up friends on weekends and evenings. For children 11 to 15 years old we will presume they may have additional freedom. Please tick the boxes below accordingly.

I agree with the levels of supervision offered to students at CC and I am aware on additional freedom around town or with staff members at limited times. http://www.country-cousins.com/about-us/policies*

Yes
No

The following times indicate when students needs to be back in their accommodation. Up to 10 years old: evening activities only 11 & 12 years old: 9pm 13 & 14 years old: 9.30pm 15 & 16 years old: 10.00pm 17 years old: 10.30pm

Step 1 of 3

STUDENT DETAILS

Terminology

MEDICAL CONSENT

PUBLICITY

TRAVEL

ADDITIONAL FREEDOM

DECLARATION

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