Registration Form

PLACE REQUIRED

Please choose*Nursery: (Ages 2 - 5) and ReceptionLower Prep: (Forms 1 - 4 )Prep School: (Forms 5 - 8)Senior School: (Forms 9 - 11)

Proposed Form, Term and Year of Entry:* Have you registered your child’s name at any other school(s) and if so, which?*

CHILD’S DETAILS

Surname of child:* Forenames (in full):* Preferred Name:*

Gender*BoyGirlOther

Date of birth:* Nationality:*

Is your child British, Irish or Swiss and holds a British, Irish or Swiss passport?*YesNo

If you answered No to the above, please state your child’s nationality Child’s first language:* Religion: Home Address:* Postcode* Country: Attach/upload photo here: (should not exceed 10mb)* No file chosen

CURRENT SCHOOL/NURSERY/PLAYGROUP (if applicable)

Name and address of current school:* Date of entry to school:* Name of Head Teacher:*

As part of the Admissions process, we will contact your child’s current school for a confidential reference.Please tick this box if you do NOT wish us to contact the school without notifying you.

PARENT/GUARDIAN DETAILS (all sections need to be completed to move to next section)

*
	Parent/ Legal Guardian 1	Parent/ Legal Guardian 2
Title:
Surname:
First names:
Address: (if different to child’s)
Postcode:
Occupation:
Nationality:
Home phone
Mobile:

If you have parental responsibility for the child in a capacity other than as a parent of the child, please state your relationship to the child here:

SIBLINGS

Please rate the following
	Sibling names	Date of birth
1
2
3
4
5

Connections with the School

Please mention here the names of any other family members attending St Edmund’s School, or registered for entry, or any other connection you have with the School:

INDIVIDUAL AND SPECIAL EDUCATIONAL NEEDS

Are there any circumstances relating to your child of which we should be aware?*
	Yes	No
Does your child have any special educational needs or learning difficulties?
Does he/she have a report by an Educational Psychologist? Please attach a copy of the most recent Educational Psychologist’s report if you have one.
Is English their second language, or do they habitually use another language at home?
Does your child have any allergies?

Attach report here No file chosen If the answer to any of the above questions is Yes, please give details:

DECLARATION

We request that the name of the above-named child be registered as a prospective pupil and we will make payment for the non-refundable Registration Fee of £75.

Reference: Please use your child's full name as the reference for the stripe payment.

registration of our child as a prospective pupil does not secure our child a place at the School but does ensure that our child will be considered for selection as a pupil at the School;
if our child is offered a place at the School, such an offer will be subject to the School’s terms and conditions for the provision of educational services2, which will bind us (as the holders of parental responsibility for him/her) in the event (and from the moment) that we accept the place;
if applicable, the School may request from our child’s present school or educational institution: (a) information and a reference in respect of our child; and/or (b) information about any outstanding fees and/or supplemental charges;
the School may process any personal data about us (or either of us) and our child, including sensitive personal data about our child (such as medical details), for the purposes of:
(i) administering its list of prospective pupils;
(ii) its registration, selection and/or admission procedures, including as set out above; and
(iii) communicating with the parents of prospective pupils about the School and generally managing relationships between the School and its prospective pupils.

First signature (Parent/Legal Guardian):

Print Name:* Relationship to child:* Date:* Email Address*

Second signature (Parent/Legal Guardian):

Print Name:* Relationship to child:* Date:* Email Address*

Notes:

Parental responsibility is defined in the Children Act 1989 as “all rights, duties, powers and responsibilities and authority which by law a parent of a child has in relation to the child and his or her property”. It equates to legal responsibility for the child. If you have any doubts about whether you do or do not have parental responsibility for the child you may wish to seek legal advice.
A copy of the current terms and conditions (known as the School’s parent contract) is available for your information upon request at any time, but please note that the version of the parent contract supplied may be subject to change prior to the point in time when a place at the School for your child may be offered.

St. Edmund's School