Admissions Forms for Early Years

Please complete the below forms before your child’s first day of school. These forms are for all children joining in the Early Years (Pre-Nursery, Nursery and Reception). Please ensure you click submit after each individual form.

Medical Information and Consent
Food Allergies and Intolerances
Emergency Contacts
Paying School Fees
Paying School Fees by Direct Debit
Pupil Image Consent
Permission for other adults to collect my child from school
Trips/Circulation of Details Permissions
Ethnic Background
Sun Cream Permission
Parental Responsibility

Medical Information and Consent

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Please be advised, this is a long form with many required fields marked with a red star. If a required field is left incomplete the form will not submit to the School Office.

Child's Name *

First

Last

Child's Date of Birth *

Surgery Name and/or Doctor's Name *

Surgery Name and/or Doctor's Address *

Surgery's Telephone Number *

Record of Immunisations Received and Date

Medical History

Please tick if your child has suffered from any of the following, past or present

Chickenpox
Asthma
Eczema
Diabetes
Epilepsy or Convulsions
Hearing/Visual problems

Please give any additional information regarding the above illnesses and, if possible, the dates your child had them.

Please give details of any other medical conditions or information about your child's health that you feel is important, including any hospital admissions, fractures or operations

Allergies

Does your child suffer from any allergies? If so, please give details here or complete the Food Allergies and Intolerances Form

Has this allergy been diagnosed by a doctor? If so, please provide a letter from the practitioner detailing the condition and any diet/information sheets received. Hard copies can be sent to the school or emails can be forwarded to schoolnurse@manorprep.org

Does your child require an Adrenaline Auto Injector (AAI)?

If you have a prescribed AAI, do you give permission for the school to administer your child's prescribed AAI if necessary?

Yes, I give permission for the school to administer my child's AAI if necessary

The AAI must be supplied to the school in its original packaging labelled by the GP, in date and bear the name of the child to whom it refers.

I can confirm that my/our child has an in date adrenaline auto injector, clearly labelled with their name, which they will bring to school with them every day.

I understand that for school trips my child will not be allowed off-site if they do not have their own, prescribed auto injector with them.

Permission to administer The Manor's Emergency Adrenaline Auto Injector (AAI)

For children with prescribed AAI's. In the event of my/our child showing signs of severe allergic reaction, we/I give consent for my/our child to receive Epipen Junior 150mcg/ Epipen 300mcg via AAI and held by the school for such emergencies, as appropriate.

This permission is valid until my/our child leaves the school.

We agree to inform the school if at any time there are contra-indications to the above medicine.

Dietary Requirements

Does your child require a special diet?

If yes, please give details

Is this request for special dietary requirements the result of one of the below? Please tick

Medical Diagnosis
Religious Beliefs
Personal Preferences

If for medical reasons, please request and complete the Holroyd Howe form from our School Nurse so that the kitchen can be informed. Email schoolnurse@manorprep.org

Medication

Please list any medications including inhalers, antihistamines, creams etc. that your child requires on a regular basis and may need to be administered in school hours

Please complete a 'Request to give Medication' form when handing in medication to the School Nurse. This form can be found on the school website or in the School Office. For Pre-Nursery and Nursery children please liaise with your child's Key Person.

If you require the school to administer any medication during the school day, it will only be administered if the 'Request to give Medication' form has been completed and signed by a parent. For Prescribed Medication and Pharmacy Recommended Medication the medicine must be in date, in its original packaging and with clear dosage and storage instructions. It must be labelled by the GP/Pharmacy and must bear the name of the child to whom it refers.

Permission to administer Calpol Infant Suspension/Calpol 6+/Piriton

If my/our child is obviously in distress from an allergic reaction, high temperature, or is in pain we/I give permission for the school to administer Calpol/Piriton. The school will contact you by telephone to confirm this before administering the medication on each occasion.

This permission is valid until my/our child leaves the school.

We agree to inform the school if at any time there are contra-indications to the above medicine.

Permission to give Calpol/Piriton

I agree to my child being given the above Calpol
I agree to my child being given Piriton
I do not agree to my child being given the above Calpol
I do not agree to my child being given Piriton

Consent for Emergency Salbutamol Inhaler for children diagnosed by a doctor with asthma

I can confirm that my child has been diagnosed with asthma by a doctor and has been prescribed an inhaler.

My child has a working, in-date inhaler, clearly labelled with their name, which they will bring with them to school every day.

In the event of my child displaying symptoms of asthma, and if their inhaler is not available or is unusable, I consent for my child to receive Salbutamol from an emergency inhaler held by the school for such emergencies.

I understand that, for school trips off-site, my child will not be allowed off-site if they do not have their own, prescribed inhaler with them.

Consent for Emergency Treatment

I authorise the school, every effort having been made to get in touch with us first, on the advice of a doctor and medical staff of the hospital, to give permission on my behalf for any emergency treatment.

To ensure all staff are aware of your child’s medical/dietary needs, their photograph will be circulated to all relevant staff and displayed in the appropriate areas of the school. Please contact the School Nurse if you would prefer this not to happen.

Confirmation

I confirm that the above medical information is accurate and I confirm that I will keep the school informed of any medical or dietary changes

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Comment

Food Allergies and Intolerances

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We will always ensure pupils' medical, allergy, religious and cultural dietary needs are catered for. Please note that we are unable to offer separate arrangements based on individual food preferences. There is always a Vegetarian option available at snack and mealtimes to cater for Vegetarian and Pescetarian children. Staff encourage all children to make balanced choices across all food groups which they enjoy

Name of Child *

First

Last

Form *

PART 1: Does your child have an allergy to any of the following? *

Checkboxes

Peanuts
Nuts
Eggs
Milk
Sesame Seeds
Molluscs
Crustaceans
Celery
Gluten
Cereal containing gluten
Soybeans
Mustard
Sulphites
Fish
Lupin

1B. Has their Allergy been medically diagnosed?

1C: Does your child have a Epi-pen/Autoinjector for their allergy?

If you ticked yes to cereals containing gluten, please state below the type of cereal (eg. wheat, oat, barley etc.)

PART 2: Does your child have an intolerance to any of the following? *

Checkboxes

Peanuts
Nuts
Eggs
Milk
Sesame Seeds
Molluscs
Crustaceans
Celery
Gluten
Cereal containing gluten
Soybeans
Mustard
Sulphites
Fish
Lupin

2B. Has their Intolerance been medically diagnosed?

2C: Does your child have a Epi-pen/Autoinjector for their intolerance?

If you ticked yes to cereals containing gluten, please state below the type of cereal (eg. wheat, oat, barley etc.)

3: If your child has any other allergies/intolerances, then please state below

3B. Has this Intolerance been medically diagnosed?

3C: Does your child have a Epi-pen/Autoinjector for their intolerance?

4. Has your child been diagnosed with Coeliac Disease

5. Pre-plated meal

Where a pupil’s requirements are complex (for example multiple allergies, severe allergies which have been medically diagnosed or medically diagnosed allergens that do not fall under the 14 listed allergens of the Food Information Regulations), it may be necessary to provide the pupil with a plated meal. The menu cycle for this pupil will be planned, and a meal will be prepared in a separate area or at a separate time from the meals containing the pupil’s allergens. The meal will be wrapped and labelled to protect it from cross-contamination and checked by two members of the catering team

5B: If we deem it necessary for the safety of your child, do you agree that we may prepare a plated meal? *

6. Please state below any dietary preferences (eg vegetarian, vegan etc.) *

Parent/Guardian Acceptance

Whilst Holroyd Howe can provide meals which do not include nominated allergens, we cannot guarantee that dishes do not contain traces of allergens, as they will be stored and prepared in the same areas as nominated allergies. There is a risk of cross-contamination on display counters, particularly self service areas such as salad bars and dessert counters. Please be aware that while Holroyd Howe do not use nuts in any of the food they prepare and serve they are unable to guarantee that dishes/products served are totally free from nuts/nut derivatives, due to the use of precautionary allergy statements such as ‘may contain’ which are used by their suppliers. Once this completed form has been received, a meeting can be arranged between the catering manager, school and the parent/guardian to discuss your child’s food requirements in more detail.

I'm happy for my child's allergen information and photo (where provided) to be passed to Holroyd Howe to enable them to assist the school in correct food provision *

All information will be shredded when either confirmation of no allergens or intolerances, or when your child leaves the school.

Confirmation *

Yes, I confirm that the information supplied within this document is correct. Any changes in my child's allergy/intolerance status will immediately be highlighted to the school in writing.

Parent's Name *

First

Last

Parent's Daytime Telephone Number *

Parent's Email *

Name

Emergency Contacts

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Child's Name *

First

Last

Please list any siblings also joining The Manor. This form only needs to be completed once per family.

Name of emergency contact (other than parents) *

First

Last

Relationship to child/ren *

Mobile Phone Number *

Home Phone Number

Email Address *

Third Contact - to be used in an emergency and must be UK based

Name

Ethnic Background

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All schools are now required by the Department for Education to record the ethnic background of your child and any languages spoken. To quote from their rubric “Our ethnic background describes how we think of ourselves. This may be based on many things, including, for example, our skin colour, language, culture, ancestry or family history. Ethnic background is not the same as nationality or country of birth.”

Any information you provide will be used solely to compile statistics on diversity within the School. These statistics will not allow any individual children to be identified.

Child's Name *

First

Last

Gender *

Male
Female

Nationality *

Religion (optional)

Please enter details below if your child has item(s) of jewellery which they wear for religious reasons (optional)

Child's first language *

Other languages spoken

Ethnic Background (please select)

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Phone

Paying School Fees

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Fee accounts are payable in advance and due by the first day of each term.

Termly Direct Debit
The amount due for school fees paid by termly direct debit will be collected from your bank on the first day of each term. No other notification will be sent.
Monthly Direct Debit
We accept payment of a particular school term’s fees by four instalments during that term which would be taken on or after the 3rd of each month. The Autumn Term is collected in August, September, October and November; Spring Term in December (as soon after the end of term as possible), January, February and March; Summer Term in April, May, June and July. Parents have the option to pay for tuition fees only by Direct Debit or tuition fees and all extras. Please indicate your preference on the direct debit form

Child's Name *

First

Last

Please indicate how you would like to settle your fees

If someone other than you will be paying the fees, please enter their name and contact details below

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Phone

Paying Fees by Direct Debit

To pay your fees by Direct Debit, please print, complete and return form below to The Bursary at the address provided as soon as possible.

Direct Debit Form

Pupil Image Consent

Pupil Image Consent

Please complete the permission form having read the Pupil Image Consent Letter below regarding the use of your child’s image (photo or video) and as described in the school’s Privacy Notice.

Pupil Image Consent Letter

For events involving swimmers, photographs and video recording are not permitted under any circumstances.

Parents are not to use their mobile phones for any purpose in the presence of Early Years Foundation Stage children (Pre-Nursery to Reception) except where staff have advised this is appropriate.

Please now complete the below form

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Child's Name *

First

Last

(i) Internal Use *

Yes, I give consent to my child’s images (moving or still) being used internally
No, I do not consent to my child’s images (moving or still) being used internally

(ii) External Use *

Yes, I give consent to my child’s images (moving or still) being used externally
No, I do not consent to my child’s images (moving or still) being used externally

Agreement *

I confirm that I have read the Pupil Image Consent Letter and chose the above options

Parent's Name *

First

Last

I understand that if consent is given, I may withdraw this at any time in the future by sending an email to Katherine Sherbourne - ksherbourne@manorprep.org

The school uses CCTV cameras which will capture pupils around the site.

Comment

Permission for other Adults to Collect my Child from School

Please list the names of adults who have your permission to collect your child

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Child's Name *

First

Last

Class *

Adult's name

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Website

Trips/Circulation of Details Permission

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Child's Name *

First

Last

1. Trips

This is a permission request to cover your child being taken on school trips, as well as to swimming lessons, Forest School and sports fixtures (both in and outside of school hours) during his/her time at The Manor. This will apply for trips within the UK and we will send you details of all trips before they take place. We will inform you about each individual trip but unless your child is in Nursery or Reception, we will not trouble you for permission slips for each trip. However, for residential trips we do require your written permission (the signature of both parents is required if the trip is outside the UK). An outline of each year group's trips appears in the Parents' Handbook, though this is subject to change.

Trips during normal school hours: These are covered by the fees therefore there is no extra charge.

Residential Trips (UK and overseas): Chargeable and added to your bill.

Other Trips (voluntary/out of normal school hours): Chargeable and added to your bill.

The bus companies we use all have appropriate safety restraints (seat belts or lap belts) and the children will be expected to use them at all times, unless written permission is received from you stating otherwise.

Any child who requires an inhaler or AAI will not be allowed off site without them.

Please note that for all trips where home packed lunches are permitted, these must be nut-free.

Parents/Guardians of children in the Early Years (Pre-Nursery, Nursery and Reception classes) will be required to complete a signed consent form for each outing, as well as for swimming lessons.

You can, if you wish, tell the school that you do not want your child to take part in any particular school trip or off site activity.

I/We give permission for my/our child to take part in trips and outings during his/her time at The Manor as described above *

I/We give permission for my/our child to be taken out of The Manor for spontaneous supervised activities or visits which may take place in the immediate locality of the school during normal school hours *

I/We will ensure that school will always have my/our correct and up-to-date contact details *

I/We are happy for our contact details to be shared with my child(ren)'s Class Representative *

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Phone

Sun Cream Permission

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Child's Name *

First

Last

The Manor uses Soltan Kids Factor 50 *

Yes, I give permission for sun cream to be applied to my child
No, I do not give permission for sun cream to be applied to my child

If you would prefer to supply another type of sun cream, please give details below and a bottle of the cream to your child's class teacher.

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Website

Parental Responsibility and Legal Contact Form

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Child’s Name *

First

Last

Please give details below of all persons who have Legal Parental Responsibility for the child named above, including anyone with Parental Responsibility living at a separate address.

Name *

First

Last

Address *

Relationship to child *

Legal Contact *

Name *

First

Last

Relationship to child *

Legal Contact *

Address (please only complete if different from address given above)

Please tick here to add an additional person. Grandparents do not need to be listed unless they have legal guardianship.

Name

First

Last

Relationship to child

Legal Contact

Address (please only complete if different from address given above)

Please tick here to add an additional person. Grandparents do not need to be listed unless they have legal guardianship.

Name

First

Last

Relationship to child

Legal Contact

Address (please only complete if different from address given above)

Confirmation *

I confirm that the information detailed above is correct

I confirm that all persons named above have Legal Contact with the child named at the top of this form

If any of the parents named above do not have Legal Contact with the child listed please provide separate details of any relevant correspondence supporting this.

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Please Complete The Below Forms If Required

Tax-Free Childcare Scheme, Childcare Vouchers information and Application Form
School Shop Order Form
Manor Association of Parents (MAP) Volunteer Form
Nappies and Nappy Cream
Milk at Snack Time

Tax-Free Childcare Scheme and Childcare Vouchers Information

Tax-Free Childcare Scheme and Childcare Vouchers

If you would like to pay for your child’s fees using Childcare Vouchers, please read the below information before completing the application form.

Childcare Vouchers

Childcare Vouchers Application Form

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Child's Name *

First

Last

Date of Birth *

Value of Monthly Voucher *

Provider *

Last term for voucher payment towards school fees *

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Phone

School Shop Order Form

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Child's Name *

First

Last

Year group joining *

Compulsory Items

Manor Swimming Hat £4.80 (Y1-Y6) (Reception from Summer Term)
Manor Rucksack £16.80 (Large, Y1-Y6)
Parker Pen £19.20 (Y4-Y6)
Parker Pen Cartridges £3.30 (Y4-Y6)

Additional Items Available

Manor Rucksack £14.40 (Small, Pre-Nursery - Reception)
Replacement Book Bag £6.60 (first one is given free)
Replacement Handwriting Pens £2.40
Baseball Sun Hat £4.80 (all years)
Legionnaire Sun Hat £3.60 (all years)
Large Velvet Scrunchie £2.50 (currently sold out)
Elasticated Hairband £2.50 (out of stock)

Extras

Manor Ted Key Ring £3.60
Manor Ted Plush Toy £9.60
Manor Umbrella £20.00

Confirmation *

By submitting this form you agree for the total amount spent to be added to your school bill.

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Manor Association of Parents Volunteer Form

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MAP Volunteer Form

The Manor Association of Parents (MAP) is the hub of our parent community which we rely on for welcoming new parents, organising and supporting social events for families, parents and children and helping with fund-raising endeavours… amongst other things! If you would like to get involved in any way, please complete this form and we will get in touch with you to see what role you could play. Thank you.

Parent's Name *

First

Last

1. Child's Name *

First

Last

Telephone number to be contacted on

Email address to be contacted on

Preferred method to be contacted on

Email
Phone
Both

Permission to share my details *

I give permission for my details to be shared with the MAP Committee

Name

Nappies and Nappy Cream

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Child's Name *

First

Last

The Manor uses Sudocrem Antiseptic Healing Cream

Yes, I give permission for Sudocrem to be applied to my child
No, I do not give permission for Sudocream to be applied to my child

Whilst my child is using nappies, I will provide these to The Manor

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Phone

Milk at Snack Time

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School milk is provided for children in Pre-Nursery, Nursery and Reception. Please complete the below form if you would like your child to receive milk at break times. Please be aware, for the school to receive the milk, we are required to supply a list of children and their dates of birth to the third party milk supplier.

To help avoid any confusion, please could you also remember to tell your child that they should be having milk at break time - thank you.

Child's Name *

First

Last

Date of Birth *

Yes, I would like my child to be given milk

Parent's Name *

First

Last

Email *

GDPR Agreement *

I consent to this website storing the information I have submitted in order to respond to my enquiry.

Website

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