Westhaven School Learner Information/Medical Form
Sign in to Google to save your progress. Learn more
Email *
Learner's Name *
Learner's Date of Birth *
MM
/
DD
/
YYYY
Learner's Main Address *
Parent/Carer (1) - Name *
Parent/Carer (1) - Email *
Parent/Carer (1) - Phone No. *
Separate with comma if more than one.
Parent/Carer (1) - Address *
Parent/Carer (2) - Name
Parent/Carer (2) - Email
Parent/Carer (2) - Phone No.
Separate with comma if more than one.
Parent/Carer (2) - Address *
Parent/Carer Contact Preferences
Telephone
Email
Letter
Parent/Carer (1)
Parent/Carer (2)
Emergency Contact Numbers

It is essential that we have two additional contacts for emergency use. Please provide two contacts, OTHER than parents / main carers.
Emergency Contact (1) - Name *
Emergency Contact (1) - Address *
Emergency Contact (1) - Phone No. *
Separate with comma if more than one.
Emergency Contact (1) - Relationship to student *
Emergency Contact (2) - Name *
Emergency Contact (2) - Address *
Emergency Contact (2) - Phone No. *
Separate with comma if more than one.
Emergency Contact (2) - Relationship to student *
Swimming / RE / Sex Education *
Please indicate if you agree for your child to take part in the following:
I agree
I disagree
Swimming
Religious education
Sex and relationship education
School Vehicles *
Students may, from time to time, travel on the school minibus or other arranged transport during the normal school day, for which there is generally no charge.  At all times students will be supervised and all safety precautions will be observed.  Please indicate that you give your permission for your child to participate as detailed above.
Out of School Impromptu Visits *
We will always notify you and ask for permission when we plan a trip of a visit away from school, however from time to time we may take the children on an impromptu local visit to either of the local churches, the woods, the beach, the local shop or the park.  Children will always be fully supervised and a risk assessment will be carried out.  Please indicate that you give your permission for your child to participate as detailed above.
Photography/Filming
Occasionally, we take photographs and videos of the children at our school.

We may use these images/videos in our school prospectus or in other printed publications that we produce, on displays and on our website and social media channels. We might also send images/videos to the news media, or our school may be visited by the media who will take their own photographs or film footage (for example, of a visiting dignitary or other high profile event). Pupils will often appear in these images/videos. The news media may use the images in printed publications (including local or national newspapers), on televised news programmes or on their website. They may also syndicate the photos to other media for possible use, either in printed publications, on websites, or both. When we submit photographs and information to the media, we have no control on when, where, if or how they will be used. To comply with the Data Protection Regulations we need your permission before we can photograph or make any recordings of your child.

Please note that there are circumstances when we do not require your consent because there is another legal reason which permits us to use pupils' photos or images. For example, we keep an ID photo of each pupil on our database so that we can correctly identify pupils.

I understand that:

• The media recordings will be held in accordance with the school’s Privacy Policy and the Data Protection Act / UK General Data Protection Regulation (UK GDPR);
• I can change my consent at any time by updating this form or by contacting the school office. If you withdraw consent we will stop using your child's images or videos as per your preference but we may still need to retain a copy of the photograph or video for other reasons, for example, where it is needed to perform our public task of providing education. Please note that images and videos already in circulation on the school website, on printed materials and elsewhere will continue to appear in these publications.

IMPORTANT: If your child is over 13 years of age they must also consent.
Photography/Filming Consent *
I hereby consent to Westhaven School using media recordings of my above-named child caught in audio/video recordings, and/or photographs and/or other types of media
Yes
No
In the school (activity boards, screens, reception area etc)
On the school website (www.westhavenschool.org.uk)
On the school social media channels (Facebook/Twitter)
In printed materials (school newsletter, school prospectus etc)
In the media (local/national press)
Photography/Filming Consent - Learner *
If you've chosen to give consent and your child is over 13 years old please tick 'I agree' to confirm that your child is also giving his/her consent. If you've chosen not to give consent or your child is under 13 please select 'Not applicable'.
Parent/Carer Acceptable Use Policy

Digital technologies have become integral to the lives of children and young people, both within schools and outside school. These technologies provide powerful tools, which open up new opportunities for everyone. They can stimulate discussion, promote creativity and stimulate awareness of context to promote effective learning. Young people should have an entitlement to safe internet access at all times.

This Acceptable Use Policy is intended to ensure:

• that young people will be responsible users and stay safe while using the internet and other communications technologies for educational, personal and recreational use.
• that school/academy systems and users are protected from accidental or deliberate misuse that could put the security of the systems and users at risk.
• that parents and carers are aware of the importance of online safety and are involved in the education and guidance of young people with regard to their online behaviour.

The school will try to ensure that students/pupils will have good access to digital technologies to enhance their learning and will, in return, expect the students/pupils to agree to be responsible users. A copy of the Student / Pupil Acceptable Use Policy is available on the school website so that parents/carers will be aware of the school expectations of the young people in their care.


Either: Middle and Upper School

I know that my son/daughter has signed an Acceptable Use Agreement and has received, or will receive, online safety education to help them understand the importance of safe use of technology and the internet – both in and out of school.

Or: Lower School

I understand that the school has discussed the Acceptable Use Agreement with my son/daughter and that they have received, or will receive, online safety education to help them understand the importance of safe use of technology and the internet  – both in and out of school.


I understand that the school will take every reasonable precaution, including monitoring and filtering systems, to ensure that young people will be safe when they use the internet and systems. I also understand that the school cannot ultimately be held responsible for the nature and content of materials accessed on the internet and using mobile technologies.
I understand that my son’s/daughter’s activity on the systems will be monitored and that the school will contact me if they have concerns about any possible breaches of the Acceptable Use Policy.
I will encourage my child to adopt safe use of the internet and digital technologies at home and will inform the school if I have concerns over my child’s online safety.


Parent/Carer Acceptable Use Policy *
Please tick the box below to indicate that you read and understand the Parent/Carer Acceptable Use Policy.
Required
Land Based Studies

During Land Based Studies lessons there will be times when your child may be in contact with the general public when they come into school to purchase plants, however your child will be supervised at all times by a member of school staff.

If you have any queries/concerns re this please contact the school.  

Privacy Notice

We process your personal data and that of your child in accordance with data protection laws. For more details on the processing please read our Privacy Notices for Pupils and Parents which can be found on our website under the About Us / Policies section.

https://westhavenschool.org.uk/policies/
Privacy Notice *
Please tick the box below to confirm that you have access to the Pupil and Parents Privacy Notices.
Required
Student’s Ethnic Origin
Optional
Clear selection
Country of Birth
Optional
Home Language *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Westhaven School. Report Abuse