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Summer School Permission Slip
Thank you for completing an expression of interest. The following form is a legal requirement for your child to secure a place at the Co-op Academy Leeds 2021 Summer School.
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* Indicates required question
Programme
Childs Name
Your answer
I give permission for my child to attend Summer School activities from Monday 26 July to Friday 30 July 2021.
Yes
No
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They attend the following primary school...
Please insert your child's primary school name here
Your answer
Emergency Contact 1 - Name
Name
Your answer
Relationship
Relationship to the child (Mother, Father, Uncle, Aunty)
Your answer
Emergency Contact 1 - Phone Number
Phone Number
Your answer
Emergency Contact 2 - Name
Name
Your answer
Emergency Contact 2 - Phone Number
Phone Number
Your answer
Relationship
Relationship to the child (Mother, Father, Uncle, Aunty)
Your answer
Please let us know of any medical issues or medication that your child is currently taking:
Your answer
I understand that I will be contacted if my child's behaviour is not acceptable and requested to pick them up.
*
Yes
Required
Signed:
Insert name (parent/carer)
Your answer
Submit
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