Admissions Forms for Years 3 to 6

Medical Information and Consent

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 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

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)?

Yes
No

If yes, 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)

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.

Yes
No

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.

Yes
No

Dietary Requirements

Does your child require a special diet?

Yes
No

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.

Yes
No

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.

Yes
No

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 *

Comment

Emergency Contacts

Child's Name *

First

Last

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

First Parent/Guardian

Name *

First

Last

Relationship to child/ren *

Current Address *

Mobile Phone Number *

Home Phone Number

Additional Daytime Phone Number

eg: Work

Primary Email Address *

Secondary Email Address

Second Parent/Guardian

Name *

First

Last

Relationship to child/ren *

Current Address (if different from above)

Mobile Phone Number *

Home Phone Number

Additional Daytime Phone Number

eg: Work

Primary Email Address *

Secondary Email Address

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

Name

First

Last

Relationship to child/ren

Mobile Phone Number

Additional Daytime Phone Number

eg: Work

Parent's Name *

First

Last

Email *

Phone

Paying School Fees

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

1. 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.
2. 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

Parent's Name *

First

Last

Email *

Phone

Paying 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

Photography Policy and Permission

Photography Policy and Permission

Please read the below extract from The Manor’s Safeguarding Policy below regarding Photographs, Recording Equipment and use of Mobile Phones and other Handheld Devices. Please then complete the Photography Permission form further down.

Extract from Safeguarding Policy

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. In this case, the guidelines above must be adhered to.

Please now complete the following form

Child's Name *

First

Last

Photograph Permission Agreement - Ways in which your child's image (moving or still) may be used.

1. On internal or digital display boards around the school where pupils and or their work may or may not be identified by name.

2. All pupils are photographed on entry to the school for identification purposes and for legitimate school use eg for health purposes.

3. On the school’s website and social media channels (such images will not be accompanied by a pupil’s name).

4. Distributed via the school’s promotional material, online and in advertisements (such images will not be accompanied by a pupil’s name).

5. Video recordings of drama productions will be taken to enable parents to purchase DVD’s of these events.

6. School Photographs (by an external company) for parental purchase.

7. For press use and third party use (eg a school hosting an event who may wish to use Manor photos), permission will be sought from parents on a case by case basis.

Agreement *

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

Parent's Name *

First

Last

Email *

I understand that if consent is given, I may withdraw this at any time in the future by sending an email to Kerry Arnold.

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

Message

Permission for other adults to collect my child from school

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

Trips/Circulation of Details Permissions

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.

2. Manor Association of Parents (MAP) information sharing.

The Manor uses a website called Classlist.co.uk for parents to communicate with each other.

Upon arrival at the school we would like to share the contact information for both parents with the relevant Form Representatives so that they can make contact with you, introduce you to the year group and answer any questions you may have.

If you would rather we did not circulate these details we do understand and would be grateful if you could indicate this below.

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 *

Yes
No

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 *

Yes
No

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

Yes
No

I/We are happy for the details as described above to be circulated amongst other parents *

Yes
No

Parent's Name *

First

Last

Email *

Email

Ethnic Background

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 *

Comment

Chromebook Home School Agreement

Chromebook Home School Agreement

Please click on the below link to read the agreement

The Manor Chromebook Home School Agreement

Once you have read the agreement all parents are required to please complete the Chromebook Home School Agreement Form.

E-Safety and Acceptable Use Policy and Acknowledgment Form

E-Safety Agreement and Safe Use of the Internet

Please click on the link below to read the letter from our Deputy Head Pastoral with regards to safe use of the internet:

E-Safety Agreement and Safe Use of the Internet Letter

Once you have read the letter and discussed section D of our E-Safety and Acceptable Use Policy with your child/ren, all parents are required to please complete this E-Safety and Acceptable Use Policy Acknowledgement Form.

Swimming Competency

Please complete the below Swimming Lessons form if your child is joining Reception or above. The school provides ‘noodles’ to support pupils who lack confidence.

Please be aware that The Manor takes children off site for swimming. Your child may be out of their depth in the the pool and may not be tall enough to stand, even in the shallow end.

Child's Name *

First

Last

Year Group Joining *

Can your child swim? *

If your child can swim, please state the distance they can swim

Is your child confident in the water?

If your child has swimming lessons, please give details of their class/teacher/swim school and any badges awarded

Parent's Name *

First

Last

Email *

Name

Maths Information

Maths Information

Please could we ask all parents joining Years 1-4 to read and digest the following Maths letter – Years 1-4 Abacus Maths

Final Consent

Final Consent

Thank you for taking the time to complete the admissions forms for your child/ren. To complete the process, please print and return the below consent form.

Final Consent Form

If you have any questions at all please contact Nicole Burroughs on 01235 858462 or send an email.