Antrim & Lisburn Flux Local

  • Flux Consent Form

    To be completed by the young person's parent/guardian.

  • Thursday 30 April 2026

    7:00pm - 8:30pm

    Exodus, Lisburn

     

    For anyone in Year 13 or 14

    Workshops | Games | Food | Small Groups

     

    Event Organisers

    SUNI Antrim & Lisburn Schools Worker (courtney@suni.co.uk)

    SUNI Youth Ministry Coordinator (sarah@suni.co.uk)

     

     

    Please complete one form per young person.

  • Young Person's Information

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  • Medical and Dietary Information

    The information you provide in this section will be used to help keep your young person safe and well during this SUNI Event.  SU Staff will hold this information and, where necessary, it will be shared with other team members e.g the first aider.  In an emergency it will be shared with medical staff. This information will only be kept for the duration of the event before being deleted.
  • Medical Conditions*
  • Does your young person carry an EpiPen?*
  • Do you give permission for the trained first aider at this event to administer your young person's EpiPen?*
  • Clear

  • Thank you for your response. The Event Organiser will be in touch to discuss the options for your young person's involvement at this Event.

  • Does your young person have any dietary requirements*

  • Additional Needs and Support

    The information you provide in this section will be used to help SUNI plan for the various elements of this event. SU Staff will hold this information and it will only be shared, where helpful, with other team members e.g. on a need to know basis e.g the first aider.  In an emergency it will be shared with medical staff. This information will only be kept for the duration of the event before being deleted.
  • Should we be aware of any additional needs of your young person and/or support required that would be relevant to this event?*

  • SUNI want to make our events accessible to every child and/or young person who would like to attend.  

    We seek to work with parents/guardians to welcome and include children/young people with additional needs and those who require additional support.

    Safety and fun for children, young people, volunteers and staff is priority.  Therefore, if resources are limited and we cannot care your child/young person, the Event Organiser will get in touch.

  • Learning Needs and Support

  • Does your young person receive any support for additional needs at school?*

  • Physical Needs

  • Does your young person have any physical disabilities?*

  • Communication

  • Social, Emotional, Behaviour and Wellbeing

  • Does your young person have any social, emotional, behaviour and wellbeing needs that would be helpful for us to know?*
  • Which does your young person prefer?*
  • Does your young person have any specific behavioural issues? (e.g. copying with correction, complying with instructions)*

  • Intimate Care Need and Support

  • Does your young person require help with toileting?

  • By informing us of your young person's need you are giving permission for a member of our team (staff or volunteer) to help your young person with toileting and personal care.

  • Will a support worker be required to come to this event with your young person? (i.e. relative, youth leader)*

  • Please note: a support person must be over 18 and suitably responsible to assist your young person during this event.

  • Parent/Carer Details

  • Format: 00000 000000.
  • Does this person live at the same address as the young person?*

  • Emergency Contact

    In an emergency, if we cannot contact the named parent/carer, we will contact the person named below
  • Format: 00000 000000.

  • Permissions

  • I give permission for photographs and video footage of my young person to be used on printed materials, on the SUNI and/or on SUNI's social media accounts*

  • * All activities are planned with Health, Safety and enjoyment in mind.  However, should you wish your young person not to participate in certain activities, please contact the Event Organiser.

    ** A certified First Aider will be present at this Event. However, if you do not consent to your young person receiving first aid please contact the Event Organiser.

  • Data Protection

    The information you have given us in this form is held by the SUNI and is used to plan the event.  We do not share information with any other organisations unless there is a Safeguarding concern.  For insurance reasons your young person's information will then be securely archived.  To find out more about how we use your information please read our Privacy Policy.

  • Keep in Touch!

    Working with churches, SUNI seeks to make God's Good News known to all children and young people in Northern Ireland. Let us know if you would like to hear more about the ministry and ways you can get involved.
  • Would you like to receive SUNI's monthly Prayer News via email?*

  • Authorisation

  • This page MUST be completed by the young person's parent/guardian.

    We ask parents/guardians to review the information provided on this form before authorisation.

  • Format: 00000 000000.
  •  - -
  • Clear
  • Should be Empty: