REGISTRATION FOR A KEY WORKER SCHOOL PLACE AT THE GEOFFREY FIELD INFANT SCHOOL HUB.
From 6th April, Blagdon Nursery School and Geoffrey Field Junior School will close and pupils of key workers will need to go to Geoffrey Field Infant School if you want them to attend school.  


ONLY complete this form if you consider that you are a KEY WORKER and your child is currently attending Blagdon Nursery School, Geoffrey Field Infant School or Geoffrey Field Junior School.


IF YOU HAVE MORE THAN ONE CHILD AT THESE SCHOOLS,  YOU MUST COMPLETE A NEW FORM FOR EACH CHILD.

Sign in to Google to save your progress. Learn more
WHICH SCHOOL DOES YOUR CHILD GO TO NOW? *
YOUR CHILD'S FULL NAME *
YOUR CHILD'S DATE OF BIRTH   DAY / MONTH / YEAR *
YOUR CHILD'S YEAR GROUP *
DO YOU WANT A KEY WORKER SCHOOL PLACE AT GEOFFREY FIELD INFANT SCHOOL HUB FOR YOUR CHILD? *
IF YOU HAVE ANSWERED YES TO THE LAST QUESTION, WHICH DAYS WOULD YOU WANT A KEY WORKER SCHOOL PLACE  FOR YOUR CHILD? *
Required
DOES YOUR CHILD HAVE ANY MEDICAL CONDITIONS? *
IF YOU HAVE ANSWERED YES TO THE PREVIOUS QUESTION, PLEASE RECORD YOUR CHILD'S MEDICAL CONDITION AND DETAILS OF ANY MEDICATION THEY HAVE TO TAKE DURING SCHOOL HOURS.
PLEASE CLICK THE YES BOX BELOW TO CONSENT TO STAFF WITH APPROPRIATE TRAINING AT THE SCHOOL HUB TO ADMINISTER ANY MEDICATION THAT HAS BEEN PRESCRIBED FOR YOUR CHILD.
DOES YOU CHILD HAVE ANY SPECIAL DIETARY REQUIREMENTS *
IF YOU ANSWERED YES TO THE PREVIOUS QUESTION, PLEASE PROVIDE DETAILS OF THEIR DIETARY NEEDS
IS YOUR CHILD CURRENTLY SELF-ISOLATING BECAUSE THEY OR A FAMILY MEMBER HAVE SYMPTOMS OF CORONAVIRUS? *
IF YOU HAVE ANSWERED YES TO THE PREVIOUS QUESTION, WHAT WAS THE FIRST DATE OF SELF-ISOLATION ?
YOUR FULL NAME *
PHONE NUMBER FOR CONTACTING YOU *
YOUR EMAIL ADDRESS *
2ND EMERGENCY CONTACT.                                                      NAME & PHONE NUMBER *
KEY WORKER JOB YOU DO - YOUR JOB TITLE *
COMPANY OR ORGANISATION YOU WORK FOR *
ADDRESS OF COMPANY/ORGANISATION *
We will share the information on this form with leaders at the new School Hub. In addition, any medical information about your child will also be shared with the new School Hub leaders, those that will teach your child and the first aiders on site.  This information will be stored securely until the School Hub provision ends and will be destroyed once your child's school fully reopens.                                                                                  Tick the box below to consent to this information to be shared.   *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Geoffrey Field Junior School. Report Abuse