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Consents, permissions and agreement form

All families who have been offered a place with us for September 2020 must fill in this form before their child can start nursery school and before the end of Friday 17th July at the latest.

My name is* The child for whom I have parental responsibility is:*

EmergenciesI give permission for my child to be taken to hospital for treatment in the event of an emergency.

OutingsI give permission for my child to be taken on local outings.

Photos and videos school takes:*

	yes	no
I give permission for my child to have photos/videos taken by school staff and/or photographers employed by the school.
I consent to photographs of my child being used in their learning record.
I consent to photographs of my child being used in displays in school and on their name card.
I consent to photographs of my child being used in the school prospectus, on the school website, and on leaflets and posters advertising activities run by school.
I understand that I can request to see images taken at any time, and will do so in writing.
I have discussed this with my child, and they are happy to be photographed, although I understand that at any time should they refuse or become upset, no photographs will be taken.

Photos and videos parents/carers takeI will not take photographs/videos of other children or staff at school events without the consent of the staff or the children’s parents/carers.I will not share any photographs/videos of other children or staff I have taken at school events without the consent of the staff or the children’s parents/carers.

Internet and ITI understand that in school the only part of the internet that is accessible is filtered by the London Grid for Learning firewall.I accept that on very rare occasions these precautions may fail and the school cannot be held responsible for the nature and content of materials accessed, however I understand that the school will do everything in its power to support children if this should happen.I have read the 4 “Be Safe Online” rules on the e-safety page of this website and I will talk them through with my child, helping them to understand how they can keep themselves and others safe online.I give permission for my child to use the internet when supervised.I will not use my mobile phone on school premises.

Jewellery and precious thingsI accept that if I allow my child to wear jewellery it might get lost and they might get hurt by it, and that if they bring precious things into school they might lose them.

During the COVID-19 pandemicI will not allow my child to bring any personal items into schoolI will contact the school immediately if my child develops either a high temperature, a new continuous cough or loses their sense of smell or taste, and agree with school what steps must be taken.

I consent to the school contacting me using my:
• home and mobile phone numbers (including by text message)
• email address
• postal address
They will use my contact details in these ways:
• to raise extra money to continue to improve the experience my child has at school
• to keep me in the loop with what’s happening at school
• to let me know about extra-curricular activities on offer for my child

Please select the appropriate answer:*

	yes	no
I consent to the school contacting me as described above

Changing my mindI understand that I can change my mind at any point about the consents I have given or withheld on this form, and will let the school know by emailing school@churchhill.waltham.sch.uk, or school@lowhall.waltham.sch.uk, calling the school on 020 8520 4919 (Church Hill) or 020 8520 1689 (Low Hall), or calling into the school office.

My email address, so that I can be sent a copy of my answers:

Please confirm your consent:*I consent to the Forest Alliance of Nursery Schools storing the information I have provided here in accordance with their Privacy Policy and using it to contact me about my child and send me information about the schools.

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