Year 6 Summer School Consent Form

Year 6 Summer School Consent Form

The information you provide here is used solely for the purpose of assisting to process your summer school enrolment, and is not used for any other purpose. Once the enrolment process is complete, we will keep your data in line with our records management policy Data Protection and Privacy), after which time it will be deleted.

Child's details





 Male Female











Parent/Carer details













Alternative contact - please provide the name of an alternative contact in the event of being unable to contact you.








Medical Welfare

Please read the following information. If your child has a medical condition, please also complete the relevant sections below. For the duration of the Summer School, we will have staff who are first aid qualified, and are experienced in looking after the welfare of students. To do this effectively, we would ask for your assistance to:
- Advise us of any medical conditions, including allergies.
- Let us know when there are any changes to your child’s health / conditions.
- Ensure we always have up to date contact details for you, in the case of an emergency.


 Yes No

Managing medication

Should your child’s condition require them to be medicated whilst at the Summer School, our policy is to only accept medication from parents and carers. This enables staff to correctly administer medication. Our medical care policy (available on the Academy website) has more detail.

 I agree My child does need medication but I cannot attend my child does not need medication during the school day

Asthma / Allergies

 I agree my child does not require an inhaler or auto-injector



Please note - we can only accept medication for administration by staff, which has been prescribed by a medical practitioner. We will require an initial meeting with you to do this. It remains your responsibility to ensure your child has sufficient medication in school, and that it is in date. See our medical care policy for further details.
Please outline any food allergies/specific dietary requirements:

Permission for media



We may record images of participants. I give my consent to:


Activities



Activity Selection



Water Activity

We have arranged for pupils to participate in a variety of activities.

 Yes No


 Yes No


 Yes No

General


 S - Youth Size 6-7 M - Youth Size 8-10 L - Youth Size 12-14 XL - Youth Size 16-18


 I am unable to attend I can attend


 Yes No


 Yes No


 Yes No


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