Registration Form

Date of proposed entry: *

Child Details

First name of child *

Surname of child *

Name generally used *

Child’s Date of Birth *

Form year (e.g. Reception)*

Term of entry (e.g Autumn)*

Parents/Guardians Details

Parent 1

Title *

Forename *

Surname *

Address *

Occupation *

Nationality *

Home Phone*

Work Phone *

Mobile *

Email *

Parent 2

Title *

Forename *

Surname *

Address *

Occupation *

Nationality *

Home Phone *

Work Phone *

Mobile *

Email *

Please provide the name(s) of anyone else who has parental responsibility for the child

If separated, who does the child normally live with?

Mother
Father
NA

Are there any legal arrangements which restrict parental access?
(If Yes, please provide details in a covering letter) *

Yes
No

Please mention here the names of any other members of the family attending the school or registered for entry, or any other connection with the school?

Emergencies

Names and emergency telephone numbers of two relatives / friends if parents cannot be contacted

Emergency Contact 1: Name *

Emergency Contact 1: Phone *

Emergency Contact 2: Name *

Emergency Contact 2: Phone *

Name and Emergency telephone number of a relative / friend if parents cannot be contacted: *

Tell us more

Please state name and address of the present school/nursery: *

Name of Headteacher *

Does your child have any Special Educational needs? Please provide details of any outside agencies (e.g. Speech and Language, Occupational Therapists, Educational Psychologists) that have seen your child: *

Please provide details of date of last appointment:

How did you hear about Skippers Hill School? *

If other, please specify

Declaration

We request that the name of the above-named child be registered as a prospective pupil AND agree to pay the registration fee of £50 (payment details at the bottom of the page).

We understand that:

1. 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 as a pupil at the School;

2. The School may process personal data about our child, including sensitive personal data such as medical details, for the purpose of administering its list of prospective pupils and administering its selection procedures and we consent to the processing of our child’s personal data (including sensitive personal data) for these purposes;

3. In the event that 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 services, which will bind us in the event that we accept the place.

This form requires the signature of each of those with parental responsibility.

First Signature

Name in full *

Relationship to child *

Second Signature

Name in full *

Relationship to child *

The information you are about to submit will be used to effectively handle your enquiry in accordance with the School's admissions process. This may include email, phone and postal correspondence.

We promise to treat your personal details with the utmost care and will never share or sell your data to third parties.

You can read our Privacy Policy, here.

I am happy for my data to be processed. *

I would like to receive occasional high quality, relevant and timely emails providing details of upcoming events and insight into school life. After opting in, you can withdraw your consent at any time. To do so, please contact the School Office. Alternatively, the emails will provide an unsubscribe option.

This form should be completed and signed by the Parent(s)/Guardian(s) accepting responsibility for the payment of fees and a registration fee of £50 should be paid via BACS using the following account details, to accompany your application.

Sort code: 20-58-69
Account Number: 53644006

Please use pupil’s name as the reference when making payment. If you would prefer to pay by another method, please contact the School Office.