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Details of Student

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

Title
 Parent 1Parent 2
Surname
 Parent 1Parent 2
First Name
 Parent 1Parent 2
Relationship to Student
 Parent 1Parent 2
Mobile Number
 Parent 1Parent 2
Home Telephone Number
 Parent 1Parent 2
Email Address *Providing us with an email address will enable you to download our Arbor app, where you will be able to see your child's homework, attendance, timetable and reports. By providing us with an email address you will also be able to receive communications via ParentMail
 Parent 1Parent 2

Other emergency contact details

Title
 Contact 1Contact 2
Surname
 Contact 1Contact 2
First Name
 Contact 1Contact 2
Relationship to Student
 Contact 1Contact 2
Mobile Number
 Contact 1Contact 2
Home Telephone Number
 Contact 1Contact 2

Lunch Arrangements

Medical Details

All medicines/medication supplied to us must be in the original packaging which indicates the expiry date and is clearly labelled with your child’s name, and you agree to us administering these medicines:*
You agree to us providing treatment in the 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?*
Whilst your child is at King's Lynn Academy, do you give permission for photographs and images to be used in the following places:*
 YesNo
In King's Lynn Academy Publications
On the King's Lynn Academy website
By the local media
KLA uses biometric systems for catering and printing. The chosen method is thumbprint scanning. The process is completely safe and secure, your child will then be able to use cash loaders to top up their lunch accounts.*
 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.*