Name: Preparing for Exams
Start: 2024-07-13
End: 2024-07-13
Location: New College Worcester

Student Name*

Forename Surname

Parent / Carer / Guardian Details

Your name (First Parent/Carer/Guardian)*

Prefix First Last

Relationship to child

Your Email Address*

Enter Email Confirm Email

Your telephone number

Land line

Alternative Telephone Number (Eg Work Number)

Mobile Telephone Number*

Mobile telephone

Your Address*

House name or number Address Line 2 City County Post Code Country

Second Parent/Carer/Guardian Name

Prefix First Last

Relationship to child with vision impairment

Second Parent/Carer/Guardian Email

Second Parent/Carer/Guardian Telephone Number

Land line if different from above

Second Parent/Carer/Guardian Alternative Telephone Number

Eg Work Number

Second Parent/Carer/Guardian Mobile Telephone Number

Mobile Number

Second Parent/Carer/Guardian Address (if different from above)

House Name or number Address Line 2 City County Post Code Country

Who will be our Primary Contact (please check one box)*

Just First Parent/Carer/Guardian

Both first and second Parent/Carer/Guardians

Where did you first hear about NCW?*

Student Details

Name*

Forename Middle Surname

Legal Name (if different from above)

Forename Middle Surname

Date of Birth*

Current Age*

Please enter a number from 1 to 19.

Gender*

Male

Female

Other

Name of Current School*

Address of Current School

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

What Year Group is your child taught in?

First Language*

Ethnicity*

MEDICAL CONSENT FORM

These consents are valid while your child is at NCW.

Details of current GP*

Name of Practice, name of doctor, address and telephone number

Emergency Consent*

I give consent for any medical treatment, including surgery and/or anaesthetic, in an emergency situation as recommended by a qualified medical practitioner

I consent to my child being treated with non-prescribed medication, eg Paracetamol, Ibuprofen, cough linctus, throat lozenges, Gaviscon, anti-histamine, bite and sting spray, TCP, Sudocrem and ice packs (these are kept in surgery and the houses)

I consent to my child receiving first aid treatment in the event of an accident

Name of Student*

First Last

Name of person giving consent with parental responsibility*

First Last

Date*

Preparing for Exams