COVID lateral flow student registration form

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To process the test, we will register all participating students.
To complete this registration please fill in the form below this form is for registration only there is a separate consent statement that will also need to be completed for tests to be administered.
Please use Full legal names.

We will send an email receipt to the address provided as proof of registration (please note that once submitted this form cannot be edited). Please contact the college if circumstances change (email: covid-testing@henrycort.org or telephone: 01329 843127) :

Email *

First Name *

Last Name *

Year group

Year 7

Year 8

Year 9

Year 10

Year 11

Clear selection

Date of Birth *

YYYY

Gender at birth

Male

Female

Clear selection

Currently showing any COVID-19 symptoms?

Yes

Clear selection

Home Postcode

Parent mobile number

A copy of your responses will be emailed to the address you provided.

Submit

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