Pupil consent form

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Pupil consent form

Introduction

This consent form is for participation in tests designed to detect asymptomatic coronavirus cases. Anyone experiencing symptoms should follow government guidelines to self-isolate, even if they have had a recent negative lateral flow test.

* Please complete one consent form for each child you wish to participate in testing.

* For pupils younger than 16 years, this form must be completed by the parent or legal guardian.

* For pupils over 16 who are to provide informed consent, this form can be completed by themselves, having discussed the testing with their parents/guardian.

* For any pupil who does not have the capacity to provide informed consent, this form must be completed by the parent or legal guardian.

* Taking part in testing is voluntary. There is no expectation or obligation to participate. Nobody should be required to undergo testing without consent, and nobody should be excluded from school if they do not wish to test.

* Please read the following sections, complete the questions below and submit this form to school as soon as possible.

Email *

1. Pupils First Name. *

2. Pupils Last Name *

3. Which house tutor group is your child in? *

The Bay 07 ET

The Bay 08 SA

The Bay 09 HM

The Bay 10SNM

The Bay 11 GS

07 GG Da

07 RLH Da

08 HMJ Da

08 RH Da

09 SJM Da

09 ASB Da

09 RP Da

10 AD Da

10 DD Da

11 KAD Da

11 KD Da

07 AW Di

07 CEP Di

08 JT Di

08 PS Di

09 KS Di

09 KK Di

09 RA Di

10 CZ Di

10 CP Di

11 CE Di

11 MO Di

07 EG De

07 DE De

08 AP De

08 ED De

09 ACR De

09 PW De

10 JF De

10 GR De

10 SN De

11 CG De

11 JJ De

07 BM Dr

07 DAS Dr

08 NS Dr

08 ME Dr

09 JAT Dr

09 RLA Dr

10 RW Dr

10 EM Dr

10 AMG Dr

11 VJ Dr

11 CR Dr

Other:

4. What is your child's Date of Birth - please use this format (DD/MM/YYYY) * *

5. I have had the opportunity to consider the information provided to me by the school about this testing. *

Yes

6. I have had the opportunity to ask any questions about the Lateral Flow Teat and I have had these answered satisfactorily. *

Yes

7. For parents/carers/guardians of under 16s: I have discussed the testing with my child and my child is happy to participate. If on the day of testing they do not wish to take part, then they will not be made to do so. *

Yes

8. I have understood that my child’s data will be held and shared in accordance with the data privacy notice. *

Yes

9. I agree that if my child’s test results are confirmed to be positive, I / my child will inform the school to support contact tracing. *

Agree

10. I agree to accurately record all of my child’s test results at www.gov.uk/report-covid19-result or by calling 119 and the schools rapid results form. *

Yes

11. Consent is given to conduct a Lateral Flow test on the above named pupil. *

Yes

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