Grimsdyke School

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Admission Form 2022

Admission Form 2022

This form is applicable for students who have a confirmed offer.

The information you provide will be used in accordance with the Data Protection Policy, which can be found on the Policy page

Please complete this form and print it out. We require a signed copy.

Pupil Information (this needs to be completed by the Parent or Guardian)

Childs Legal First Name* Childs Legal Surname* Childs Preferred Name

Select one of the following*MaleFemale

Date of Birth* Childs Address (full including postcode) If your child has a sibling at the school, please provide their name and class.

Contact Details

This should be the main carer and the person the child lives with.

Priority 1 Contact - Salutation* First Name* Surname*

Select one of the following*MotherFatherGrandparentCarerOther

If other please specify (step parent, family friend) Mobile Number* Work Number Home Number Email Address* Address (full, including postcode)* Contact 2 - Salutation First Name Surname

Select one of the following:MotherFatherGrandparentCarerOther

Contact 2 Main Phone Number Contact 2 Alternative Number Email Address Address

Other Contacts

These contacts are responsible adults that you give permission:
* to be contacted in an emergency, if we are unable to contact either contact 1 or 2
* to collect your child

Contact 3 SalutationMrMrsMissMsDrOther

First Name Surname Address (including postcode) Phone number Contact 3 Alternative Number Relationship to the child

Contact 4 SalutationMrMrsMissMsOtherDr

First Name Surname Address (including postcode) Phone Number Contact 4 Alternative Number Relationship to child

Dietary

Please select which menu your child could have*HalalNon-HalalVegetarianHas allergies

If your child has allergies please state exactly what they are allergic to. Please also provide a care plan.

Medical

Has your child ever been referred to any o these specialists:Speech TherapistAudiologistOrthoptistOccupational therapistEducational PsychologistCommunity PaediatricianPhysiotherapistDietician

Please provide details of any treatment and/or other conditions GP Surgery* NHS Number Date of Childs Last Tetanus

Ethnicity

Ethnicity* First Language: Please state the first language that your child was exposed to at birth.* Religion* Country of Birth* Nationality*

Travel

Please advise of your travel arrangements to and from schoolWalkBusTrainCarTaxiCycle/Scooter

Previous School/Nursery

Please state which school/nursery your child has attended. If none, please state none.* Address and phone number of nursery

Parent/Carer's/Student Undertaking

I give permission for:My child to visit the local area on foot eg shops, places of worship, parks etc.My child to take part in food tasting (as part of topic work), including the KS1 fruit schemeMy child to receive milk during their Reception yearPhotos of my child - taken and displayed in school and/or internal learning platformsMy childs work to be displayed onlinePhotos/videos of my child to be used in the Newsletter/websitePhotos and videos to be used on social media

Terms and Conditions

Please read the statements below and tick the consent box under this section to confirm that you agree to ALL the statements below:
* I and student undertake to abide by the school rules in respect of Attendance , Behaviour Uniform and home & school study.
* I and student have read and agree to the , Internet rules and Internet permission and discipline.
* I consent to Communication being sent Home electronically and to my contact details being used for Schools Information Systems.
* Internet Permission: I and student agree to comply with the School's Acceptable User Policy.
* Data Protection: I (Parent/Carer) confirm that I have read the Privacy Notice.
* Home School Agreement: I and student have read and agree this document and that submission of this form is our agreement.
* I am aware that the school's complaints procedure is available on the school website and that other policies and important information can also be accessed there.

By clicking this box you agree to the terms and conditions as detailed above. Please print the form, sign it and return it to the school office, either in person, by post or via email.*I the Parent/Carer Agree

Parent Signature: ............................................................. Date: ...........................

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Admission Form 2022
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