Abbot's Lea School - student information form 2024-25

1. Child's surname *

2. Child's forename *

3. Child's middle name(s)

4. What name is your child known by? *

5. Date of birth *

	DD/MM/YYYY
My chil'd date of birth is...

6. Home address(es) (please provide all home addresses) *

7. Does your child have any siblings? *

If yes, please share their names and the settings they attend (if applicable)

8. Do you give permission for your child’s images to be used for school use including mediums such as social media sites, newspaper, magazines as well as prospectuses and to promote the school's successful practice? *

9. Do you give permission for your child to take part in educational visits that fall within school hours? All activities will be fully supervised with adult/child ratios adhered to *

10. Are there any types of trips that you would like to consider more carefully when making the above decision?

11. Full name of emergency contact 1: *

12. Telephone number(s) of emergency contact 1 *

13. Email address of emergency contact 1: *

14. Home address of emergency contact 1: *

15. Relationship of emergency contact 1 to student: *

16. Is emergency contact 1 authorised to pick this student up from school? *

17. Full name of emergency contact 2:

18. Telephone number(s) of emergency contact 2:

19. Email address of emergency contact 2:

20. Home address of emergency contact 2:

21. Relationship of emergency contact 2 to student:

22. Is emergency contact 2 authorised to pick this student up from school?

23. Please list any additional emergency contacts (with their details) that you wish to be saved against your child's details

24. Please list the names and telephone numbers of family members/friends who are likely to pick this student up from school and who have permission to do so: *

25. Please select your child's most common lunch choice: *

Free school meals
Paid school meals
Packed lunch

26. Do you believe you might be eligible for free school meals? (The school can run a check for this) *

27. In order for us to check your eligibility for free school meals please provide us with your full name

28. In order for us to check your eligibility for free school meals please provide us with your date of birth:

	DD/MM/YYYY
My date of birth is:

29. In order for us to check your eligibility for free school meals please provide us with your National Insurance Number:

30. Please select the student's most common way of traveling to and from school *

31. Ethnic origin *

32. Home language(s) *

33. Child's mother tongue: *

34. will you require an interpreter for meetings? *

If yes, please specify the language

35. Religion:

36. Doctor's name *

37. Surgery address: *

38. Surgery telephone number *

39. In addition to autism, please list all of your child's diagnosed SEN

40. Please list all of your child's medical conditions

41. Please list all of your child's known allergies:

42. Does your child take regular prescription medication? *

If yes, please state name, strength, dosage and administration instructions of medication

43. Is this medication to be administered at school? - PLEASE NOTE, THE STUDENT HAS THE RIGHT TO REFUSE - IF STUDENT REFUSES OR SPITS OUT MEDICATION, WE WILL INFORM FAMILY IMMEDIATELY AND WILL NOT ADMINISTER ANOTHER DOSE.

44. Paracetamol and other over-the-counter medicine can be given either:

- with written consent from the family where symptoms are present
or
- where there are no present symptoms, but it has been prescribed by a medical professional as a preventative measure and we have written consent from the family

(A prescription can be from any medical professional with the mandate to prescribe, including "care of the chemist" support)

If you feel you child needs to take over the counter medication at school, the following rules apply
- Families must inform class team when student is bringing in medication
- Families must state the reason for taking medication
- Families must provide the exact time last dose was taken
- Families must provide the exact amount of tablets/ml brought in
- Student must hand over the medication upon arrival for staff to store it safely

- 8 rights to medication would apply

1 The right person
2 The right medication
3 The right time
4 The right dose
5 The right route
6 The right position
7 The right documentation
8 The right to refuse

Please confirm you have read and understand the above *

Yes, I understand
I give written consent for over-the-counter medicine to be given when my child needs it
Other family views:

45. Are there any health professionals involved with your child? (For example - CAMHS, Paediatrician, Dietician) *

If yes, please specify:

46. Are there any other agencies involved with your child? *

If yes, please specify:

47. Do you agree to support your child to use school devices and internet in an acceptable way? *

48. Are you happy for your child to study Religious Education (RE)? *

49. In line with best practice, where developmentally appropriate, we deliver supplementary Sex Education content (to that covered in science). These lessons include learning about human reproduction and sexual relationships.
Families do have the right to withdraw their child from lessons covering this non-statutory content. However, we would urge any families to consider this carefully. Please be reassured any content is delivered in an age AND developmentally appropriate way.

Are you happy for your child to recieve such education? *