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Form from: Coppetts Wood Primary |
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Admissions Form : Personal Details
In order to improve the way in which we communicate with parents and carers, we have produced a single form enabling us to gather the data necessary to communicate with you effectively for the duration of your child’s education at Coppetts Wood Primary .
Please ensure the contact details and other information regarding your child is kept up to date. If you change your details at any time, please let the school office know as soon as possible.
Pupil Details
Legal Forname
Middle Name
Legal Surname
Known Name
Gender as of birth
Gender identified as now (if different)
Date of Birth
Line 1 - Name or House Number
Line 2 - Street
Line 3 - Town
Line 4 - County
Post Code
Parent Carer 1 / 2 Details
Details of Parent / Carer 1 that has legal responsibilities
Please give details below of all persons who have parental responsibility - the parent / carer completing this form must inform the school of any individuals with parental responsibility. (Parental responsibility can only be removed by Court Order - for more information about parental responsibility please visit www.gov.uk/parental-rights-responsibilities .)
Title
Name
Surname
Relationship
Other
Parental Responsibility
Address
Home Number
Mobile Number
Email Address
NI Number
Place of Work
Job Title
Work Phone Number
Details of Parent / Carer 2 that has legal responsibilities
Title
Name
Surname
Relationship
Other
Parental Responsibility
Please indicate if this is the address that the pupil normally resides (i.e. sole or shared residency) using the tick box
Address
Is there a Court Order in place?
Do they require a School Report
Home Number
Mobile Number
Email Address
NI Number
Place of Work
Job Title
Work Phone Number
If there is any other person who can be deemed a ‘parent’ (eg. step parent, or parent’s partner) please provide their details below, indicating if they have 'parental responsibility'.
Title
Name
Surname
Address
Relationship (Step Father, Step Mother or parent’s partner)
Parental Responsibility
Mobile Number
Email Address
Other Contacts
OTHER CONTACTS
Before disclosing details below of anyone else you wish to be contacted in an emergency, you must ensure you have obtained consent from the individual(s) concerned. Please list contacts in order of preference - 1st contact = first preference.
Title
Name
Surname
Home Number
Mobile Number
Relationship to pupil
Do you wish to add an additional contact?
Title
Name
Surname
Home Number
Mobile Number
Relationship to pupil
Do you wish to add an additional contact?
Title
Name
Surname
Home Number
Mobile Number
Relationship to pupil
Brothers / Sisters in this School
Name and the Form of Brothers / Sisters in this School
Name and the Form of Brothers / Sisters in this School
Name and the Form of Brothers / Sisters in this School
Medical Information
Surgery Name and Address
Any known Medical Conditions? (Epilepsy, Asthmatic) or Allergies?
Any Dietary Needs or Food Allergies? (Please specify e.g. Gluten Free / Coeliac)
Previous School Details
School Name / Address / telephone number
Ethnic / Religious Information
Religion
First Language Spoken at Home?
Ethnicity
Please tick ONE from the following options
Pre Nursery Applicants Only
Some children are eligible for funding for 15 free hours of childcare per week. This is true if you are in receipt of one of the following benefits:
- Income Support
- income-based Jobseeker's Allowance (JSA)
- income-related Employment and Support Allowance (ESA)
- Universal Credit, and your household income is £15,400 a year or less after tax, not including benefit payments
- child tax credits, and your household income is £16,190 a year or less before tax
- the guaranteed element of Pension Credit
- the Working Tax Credit 4-week run on (the payment you get when you stop qualifying for Working Tax Credit)
This is also true if your child:
- is looked after by a local authority
- has a statement of Special Educational Needs (SEN) or an Educational, Health, and Care (EHC) Plan
- receives Disability Living Allowance
- has left care under an adoption order, special guardianship order, or a child arrangements order
Please ensure you check with your local council to see if you are eligible. If you are in Barnet, you may contact the Brokerage Team on 020 8359 3052.
Unfortunately, eligibility does not cover the cost of meals or other consumables (e.g. nappies etc) and so these may come as additional costs.
Funding
If you have a reference code, please state this below:
If you do not qualify for 15 hours of free education for your 2 year old, there is an opportunity to pay for these sessions. The cost is £7 per hour - this works out as £21 per day for a Morning or Afternoon place or £45.50 for an All Day place.
Please let us know which session you would prefer
Nursery Applicants Only
Every child is eligible to 15 hours of free childcare the term following their 3rd birthday.
Some children maybe eligible for 30 hours free childcare the term following their 3rd birthday. Please provide us with your unique 11 digit code as proof of eligibility.
All places are allocated to children who meet the admissions criteria and confirmed when an offer has been accepted.
Unfortunately, eligibility does not cover the cost of meals or other consumables (e.g. nappies etc) and so these may come as additional costs.
Please tell us which preferred session/s you would like
30 Hour Code
All codes must be valid the term before the child starts Nursery, regardless of start date. Therefore, parents and carers will need to validate the code to access the funding by the following dates:
Valid by date: 31 August Term funding will start: Autumn Term
Valid by date: 31 December Term funding will start: Spring Term
Valid by date: 31 March Term funding will start: Summer Term
I am eligible for 30 hours free childcare
Please enter your valid unique 11 digit code
Declaration
Data Protection Statement:
The purpose of this form is to collect data for further processing within the school/Local Authority/DfE systems. Your signature on this form implies your consent for the school/Local Authority/DfE to process the data. The data will be processed fairly and lawfully in accordance with the Data Protection Act/GDPR. The information given will be entered onto a computer and will form part of the school’s database.
Please see the School’s Privacy Policy for more details on how we use pupil information.
Declaration of Person with Legal Responsibility
I declare the above information to be correct to the best of my knowledge at the time of completion.
I agree to notify the school any changes in my child’s circumstances.
Parent's Name
Please sign below
please use your mouse or finger sign above
Permission Form - Mobiles, Collection & Home Alone
Child's Name
Year
For safeguarding reasons, it is important that we know the going home arrangements for your child at the end of the school day.
My child will be collected from school
For safeguarding reasons, it is important that we know the going home arrangements for your child at the end of the school day. The following people, apart from Parents and Carers, can collect my child:
Name
Relationship to child
Name
Relationship to child
Name
Relationship to child
Years 6 only
My child can go home from school alone
I understand that:
If these are not adhered to, I understand that the phone will be locked away in school until I, the parent or carer, am able to collect it.
Consent Form
Please indicate whether you give your consent to each case.
Your child can:
Have food that states it 'may contain traces of nuts
We are a nut free school. However, there may be occasions where food packaging states it 'may contain traces of nuts.'
Go on supervised visits/ sports events to local destinations (within 3 miles of school)
Use the internet and school approved websites via a secure server under supervision
Send and receive emails under supervision whilst at school
Use of your child's image
As the child's parents and carers, you must agree that if you take photographs or video recordings of your child(ren) that include other children, they are for personal and family use only. They must not be posted on social media. Where you have not gained consent from other parents and carers for any other used of these images, you will be in breach of GDPR 2018.
In school wall displays/ class activities
In external media (local newspaper/ Instagram)
In the school's annual class/ whole school photographs
Included in the school's annual individual photographs
Nursery & Reception Only: on the shared learning journal, Tapestry
Use of your contact details
Set you up to make online payments
Contact you on behalf of external providers about events/ clubs
Keep your child's contact details to contact them in the future about events for previous pupils
Tapestry Permissions
The following questions are with regards to Tapestry, the learning platform used by EYFS. Please answer if you are the parent of a child joining Nursery or Reception OR select 'this does not apply to my child' if your child is in another year group.
I agree
We resend this form to be completed annually. You may withdraw or give your consent to anything you have changed your mind about at any time by contacting the school.
Parent's Name
Date
Please sign below
please use your mouse or finger sign above