Rangers:    Parental Consent Forms, etc.

(So you can cut & paste each form, then print)

MHR-55-Form-A

MID-HANTS RAILWAY

RANGERS PARENTAL CONSENT FORM

These details will be kept confidential by the Mid-Hants Railway. They will also be held on computer at the railway headquarters, Alresford.

Applicant's Name and Details

Surname

First name(s)

Address

Postcode

Telephone No. (Home)                                            Telephone No. (Mobile)                                                    

Date of birth   .................................       MHRPS Membership No. .................................................

Please indicate the areas of the railway where your son/daughter is interested in working.

Parental/Guardian Details

Mr/Mrs/Miss/Ms Surname

First name(s)

Telephone No. (Home)                                                       Telephone No. (Mobile)

Telephone No. (Work)

Address (if different)

Postcode

I wish my son/daughter to be allowed to take part in activities associated with the Rangers. I have ensured that my child understands that it is important for his/her safety and for the safety of others that any instructions given by a member of staff are obeyed and that he/she has read and understands the Code of Safe Practice and agrees to abide by its instructions at all times.

Signature of Parent/Guardian  ..................................................................................

Date

MHR-55-Form-B

MID-HANTS RAILWAY

RANGERS MEDICAL FORM

These details will be kept confidential by the Mid-Hants Railway. They will also be held on computer at the railway's headquarters, Alresford.

Surname

First name(s)

Date of birth

Telephone No. (Home)

Telephone No. (Mobile)

Telephone No. (Next of kin)

Does your child suffer from any medical condition which may affect their performance on the Railway ?                     YES / NO

If Yes please give further details

In case of accident or illness please advise whom you wish to be notified and their contact details

Signature of Parent/Guardian  ...................................................................................

Date

  Code MHR-55-Form-C

MID-HANTS RAILWAY RANGERS CODE OF SAFE PRACTICE

1. No Ranger may work for more than 8 (eight) hours in any 24 hour period.

2. Rangers may only work under the supervision of a Rangers Supervisor and/or Nominated Minder suitably qualified, and experienced in the work to be done by the Ranger.

3. The Ranger must be rostered to do such work and be in possession of a valid Ranger Identity Card.

4. Rangers who work must sign on at the beginning of each duty in the appointed place and sign off at the end of each duty. The Mid-Hants Railway cannot take responsibility for Rangers outside of this period and travel to and from the duty point is the responsibility of parents, except when a Ranger is using a train for this purpose.

5. Rangers are not allowed to stay overnight anywhere on Railway premises except in Ranger-organised groups arranged with the full consent of the Mid-Hants Railway management.

6. Rangers are not allowed to operate heavy machinery, machine or high-powered tools. Neither are they allowed at any time to drive, fire, signal or control train movements. Those who attain 14 years of age may become Junior Porters with the consent of a Ranger Leader and Stationmaster, but may only work as such under adult supervision.

7. Travelling on trains except to and from a rostered duty is not allowed unless under the supervision of a responsible adult. The Ranger pass must be carried at all times.

8. Rangers should attend suitably dressed for the job they are to undertake: jeans/shorts/T-shirt are not suitable for catering outlets and boys should wear a tie - as with other uniformed jobs;  for lineside/loco work, old clothes, overalls, strong shoes and waterproofs are a necessity. Rangers should try to obtain their own orange-coloured hi-viz vest.

9. Rangers may not hold a PTS (Personal Track Safety certificate). Those under 16 years of age are not allowed on or near the track unsupervised and are only permitted on or near the track if working with an adult who holds a P.T.S.

10. Rangers may not handle alcohol at any time.

11. Railways are by their nature dangerous places to work, but can be rewarding and enjoyable if treated with respect and safety is uppermost in all that is done.

12. Failure to observe the clauses in this code could result in dismissal.

This Code of Practice forms part of MHR 55 'New Entrants, Rangers and Induction Training'  - July 2002

Mid Hants Railway: Application for Identity Card

Please complete all sections of this application form and then submit it, with one passport-sized photograph, to your Local Manager for authorisation.     If you want the card sent to your home address, please enclose a stamped, addressed envelope.

Personal details

If you are a first aider, when does your certificate expire? ................................

Title ............ Surname  ..........................................................................................Forename .....................................................................

Home address .............................................................................................................................................................................................

Post code ..............................     Tel Nos.........................................................................................  E-mail.................................................

Date of birth  ......................................................

Please give details of the person to be contacted in case of emergency:

Name  .........................................................................................................       Relationship  .........................................................

Address (if different from above) .......................................................................................................... Postcode  ...........................

Contact telephone numbers:  At home ....................................................      During Working Hours..............................................

Category (Please circle):    Paid Staff     Working volunteer     Other (Please write in)......................................

If you are a Working Volunteer please give:

Main Department

Other Departments

MHRPS Membership number  ........................................   Special qualifications  .............................................................

Note: Information on this form will not be passed to third parties. The details you provide will be held on a computer database and hard copy for use on the MHR.

Authorised by ........................................................................ (Local Manager)                                   

Expiry date .........................                      Card No........................................... 

Issued by  ....................................             Date.................................................