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Details of Student

Details of Parents/Carers Living at the home address who have parental responsibility

 Parent 1Parent 2
 Parent 1Parent 2
 Parent 1Parent 2
 Parent 1Parent 2
 Parent 1Parent 2
 Parent 1Parent 2
 Parent 1Parent 2

Emergency contact details (other than parents/carers)

 Contact 1Contact 2
 Contact 1Contact 2
 Contact 1Contact 2
 Contact 1Contact 2
 Contact 1Contact 2
 Contact 1Contact 2

Lunch Arrangements

Medical Details

All medicines must be supplied in the original packaging which indicates the expiry date and are clearly labelled with the student's name. I agree to members of staff administering medicines/providing treatment to my child as directed above or in case of emergency where considered necessary.*

Special Educational Needs (SEN)

Does your child have any special needs provision?*
If yes, is your child on the SEN register at their current school?
Does your child have an EHCP?

Other Information:

Travel Arrangements
Is a parent/carer a serving member of the armed forces?*
 YesNo
In King's Lynn Academy Publications
On the King's Lynn Academy website
By the local media
 YesNo
I am willing for my child to use the Academy recognition system
ICT/Internet policy - As a parent or legal carer of the above pupil, I grant permission for my son or daughter to use the internet at King's Lynn Academy. As a user, your child will agree to use the network in a responsible way and observe any restrictions. I understand that some materials on the internet may be objectionable and I accept responsibility for setting standards for my son or daughter to follow when selecting, sharing or exploring information and the media.*
Sanctions - Your child will abide by the Academy's rules and sanctions, and you agree to them attending after school detentions.*

The 3 questions below are optional, and are collected only for school use to support multi-cultural activities and support student services. Providing this information is voluntary.

Has any member of your household received higher education e.g. university?
Is your child adopted?
Is your child a young carer?
I certify that to the best of my knowledge, the information on this form is correct.*