Permission | Natural Leaders

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Please fill in one form for each young person taking part in Natural Leaders NZ. We need it back before their first session.

Natural Leaders is run by Every Body Is A Treasure Charitable Trust (CC56586). Our rangatahi plant food forests at schools, learn regenerative growing and bushcraft, build with recycled materials, and spend a lot of time outdoors in all weather. There is no cost to attend.

If anything changes during the year (health, contact numbers, photo choices), just let us know and we will update your form.

Questions: Mandi, mandi@naturalleaders.nz
Our policies (child protection, health and safety, risky play): naturalleaders.nz/policies

Participant details

Young person's full name *

First

Last

Preferred name

Date of birth *

School and year level *

Iwi / hapū (optional)

Home address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Young person's mobile (if they have one)

Parent or caregiver

Caregiver 1 name *

First

Last

Caregiver 1 relationship to young person *

Caregiver 1 mobile *

Caregiver 1 email *

Caregiver 2 name

First

Last

Caregiver 2 relationship to young person

Caregiver 2 mobile

Caregiver 2 email

Emergency contacts

People we can call if we can't reach you.

Emergency contact 1 name *

Emergency contact 1 relationship *

Emergency contact 1 phone *

Anyone who is NOT allowed to collect your young person or have contact with them during sessions

Health and medical

This stays with the lead facilitator and comes with us on every trip. Please tell us anything that would help us keep your young person safe and well.

Allergies (food, insect stings, plants, medication) *

Write 'none' if there are none.

Medical conditions (asthma, epilepsy, diabetes, anything else) *

Write 'none' if there are none.

Medication they carry or need during sessions

Do they carry an EpiPen or inhaler? *

Dietary needs

Anything about learning, sensory needs or wellbeing that helps us support them

Doctor's name and practice

Doctor's phone

Date of last tetanus shot (if known)

Can your young person swim 50 metres unaided in open water? *

Yes
No
Not sure

Activity permissions

Every activity runs under our health and safety and risky play policies, with a risk assessment for each site. Our two rules on every programme: don't die, and leave people and places better than you found them.

Travel in the Natural Leaders van (up to 7 seats) to sessions, schools and sites *

Food forest planting, digging and garden work at host schools and Natural Leaders HQ, 191 Plateau Road, Te Marua *

Propagation and grafting, including use of grafting knives *

Hand tools (spades, saws, hammers, secateurs) *

Power tools under supervision at Cahoots Makerspace *

Bushcraft, including knife work and lighting small fires *

Hiking and nature journalling on tracks and in the bush *

Kayaking and stand up paddle boarding *

River swimming at established swimming holes near Kaitoke *

Farm work at satellite sites and fieldtrip sites *

Preparing and sharing kai, and fundraising stalls at community events *

Walking off site in the local area during sessions *

Overnight trips and rites of passage

Some trips go overnight, including our summer rites of passage programme. We will always send dates, location, gear list and a full information pack before each trip. Please tick what you give permission for now, and we will confirm with you before every trip.

Overnight trips

Camping overnight with the group, with staff on site *

Cooking over a fire and sharing kai at camp *

Bush walks, including after dark with a torch and staff *

Travel in the Natural Leaders van to and from the site *

Summer rites of passage programme

Runs over 4 days in February, Friday to Monday, in the bush at a food forest on the Wairarapa coast. Rangatahi are back at school on the Tuesday. The Friday and Monday count as their Natural Leaders days for those two weeks, so there is no extra time off school. Open to Natural Leaders OGs who choose to take part, 8 to 10 rangatahi.

Two of the four days are solo time. Each young person spends this time on their own in a set spot with a sleeping bag and a tarp. Staff supervise from a distance, check on them at agreed times, and are close enough to respond if needed.

The programme is led by a facilitator trained in ecotherapy and wilderness rites of passage. A site visit and full risk assessment (RAMS) are done before the trip, and we will share it with you.

Taking part in the 4 day rites of passage programme *

Two days of solo time in the bush, supervised from a distance *

Sleeping out under a tarp *

A pre-trip meeting for rangatahi and whānau (we ask at least one caregiver to attend) *

Extra information for overnight trips

Any medication needed at night or first thing in the morning

Sleepwalking, bedwetting or night-time anxiety we should know about

Anything that helps your young person settle if they feel unsure or homesick

Best number to reach you overnight

Who can collect them early if needed?

Photo and video consent

We take photos and short videos to record the mahi, show our funders what their support does, and share what rangatahi are achieving. You choose how they can be used. Saying no to any of these won't affect your young person's place in the programme. The youth are offered our phones to delete any images they do not want to have seen publicly at the end of each session.

Kept in our own records and shared with the young person and whānau *

Reports and applications to funders *

Natural Leaders website and printed material *

Natural Leaders social media (Facebook, Instagram) *

News media, award entries and presentations *

Video interviews where the young person speaks on camera *

Shared with partner schools and organisations for their own newsletters *

Names with images *

First name can appear with images
No name with images

Our promises

We never publish home addresses, school uniforms that identify a school without its permission, or anything that shows where a young person can be found on a given day.
We use images that show young people with dignity, and never in swimwear on public channels.
Your young person can say no to a photo on the day, and we will respect that.
You can change these choices or ask us to remove an image at any time by emailing mandi@naturalleaders.nz. We will take it down from our own channels within 5 working days. We can't recall printed material or posts already shared by others.

Medical treatment

If my young person is hurt or unwell and I can't be reached, I give permission for Natural Leaders staff to give first aid and to arrange medical or hospital treatment, including ambulance transport. I understand I will be contacted as soon as possible. *

I agree
I don't agree (please talk to us)

Your information

We collect this information to keep your young person safe and to run the programme. It is stored securely, seen only by Natural Leaders staff who need it, and shared with medical services in an emergency. We report numbers to funders but never names or health details without your consent. Under the Privacy Act 2020 you can ask to see or correct this information at any time.

Declaration

Please tick each statement *

I am the parent or legal guardian of the young person named on this form.
The information I have given is correct, and I will tell Natural Leaders if anything changes.
I understand that outdoor learning carries some risk, that the programme manages that risk carefully, and that my young person will be challenged.
I have talked through the activities with my young person and they want to take part.

Parent or caregiver name *

Parent or caregiver signature *

Clear Signature

Young person's agreement

If your young person is 16 or over, please have them sign here too. This covers the photo choices and, if they are going, the overnight trips and rites of passage.

Young person

I have heard what the overnight trip and rites of passage involve, including the solo time. I want to take part, and I agree to stay within the boundaries we set together and to signal staff if I need help.

Young person's name

Young person's signature

Clear Signature