Acceptance Form

Acceptance Form

We're delighted that you're joining us, please fill out the form below

Child's Details

First Names of your child

Surname of your child

(please indicate name generally used)

Date of Birth

Nationality

Religion

Proposed Entry Term

Autumn

Spring

Summer

Year

Year Group

If Pre-School place, is it your present intention for the child to continue in to the Pre-Prep at 4+

Yes

No

Parent's Title, Name and Address

Occupation

Mobile Number

Daytime Telephone

Evening Telephone

Email

Parent's Title, Name and Address

Please enter N/A if this field is not applicable

Occupation

Please enter N/A if this field is not applicable

Mobile Number

Please enter N/A if this field is not applicable

Daytime Telephone

Evening Telephone

Email

Please enter N/A if this field is not applicable

Guardian - (appointed under Section 5 of the Children Act 1989, by the court or by a parent with parental responsibility, or by an existing guardian).

Please give the Title, Full Name, Address and Occupation of the Guardian and details of their appointment.

Mobile Number

Daytime Telephone

Evening Telephone

Email

a) Do both parents have parental responsibility for the child?

(If 'No' please give details in a covering letter)

Yes

No

b) Do both parents agree that the child should attend the School?

(If 'No' please give details in a covering letter)

Yes

No

c) Is there anyone else whose consent to the child coming to the School is required?

(If 'No' please give details in a covering letter)

Yes

No

d) Is it proposed that anyone other than the parents will pay or guarantee payment of the fees?

(If 'Yes' please give details in a covering letter)

Yes

No

Present school (if applicable)

Please give the name and address of the present school, if applicable (with dates). Please write N/A if not applicable.

Please inform us in a covering letter if:

The child has any known medical condition or health problems or allergy
The parents are separated or divorced
Any persons named in this form expects to change address during the next 12 months
There are any Court Orders, in relation to the child, for example as to parental responsibility, residence, contact, prohibited steps, specific issues or periodical payments in relation to the parents or if either parent is an undischarged bankrupt or subject to an individual voluntary arrangement.
The child may be unable to play a full part in the games and sporting curriculum of the School

We/I acknowledge and agree that the Standard Terms and Conditions attached to this Acceptance Form as varied from time to time form part of the contract between us/me and the School.

We/I accept the offer of a place at the School as set out in the Letter of Offer. We/I agree that by signing this Acceptance Form that a contract is in force with the School in accordance with the School's Standard Terms and Conditions. This acceptance will not be withdrawn or cancelled without giving a full Term's Notice in writing as defined in our Standard Terms and Conditions. If such notice is received by the School by that time we/I understand that the deposit will be forfeited but no further fees will be payable. If such notice is received by the School without a full term's notice being given (or if no notice is received), a term's fees shall be payable in lieu and shall become due and owing to the School as a debt.

We/I have read and understood the School's Early Years Foundation Stage (EYFS) Admission and Session Allocation Policy (for entry to EYFS).

We/I agree to pay the fees and supplemental charges when due and we/I certify that fees of the current and any previous school have been paid and that the child has not been expelled or removed from any school for misconduct.

We/I consent to the School (through the Head, as the person responsible) obtaining, processing and holding personal information about the child, including sensitive information such as medical details, for the purposes of safeguarding and promoting the welfare of the child.

By signing this Acceptance Form, we/I confirm that any information or circumstances about or relating to me/us and our/my child that has been previously notified to the School is and remains complete and accurate as at the date when we/I sign this Acceptance Form.

Each person with parental responsibility for the child is required to sign this Acceptance Form and the School is entitled to treat any instruction, authority, request or prohibition received from any person who has signed this Acceptance Form as having been given on behalf of both or all such persons.

Deposit Payment

A cheque for £600.00 has been submitted

A BACS payment for £600.00 has been made

Lloyds Bank: Great Walstead School

Account Number: 01035051

Sort Code: 30-18-30

Reference: Pupil name and surname

Singatures

Signed by

Name in full

Date

Signed by

Name in full

Date

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