ABOUT THE CHILD

First Name: Surname:

Middle Name: Name known by:

Gender: Male / Female Date of Birth:

ABOUT THE PARENTS

Mother’s Name: Title: Father’s Name: Title:

Occupation: Occupation:

Parental Responsibility: Yes / No Parental Responsibility: Yes / No

Address: Address: (If different from Mother’s)

Postcode: Postcode:

Does the child normally reside with the FATHER MOTHER BOTH OTHER (please circle)

Home Telephone: Home Telephone:

Work Telephone: Work Telephone:

Mobile Telephone: Mobile Telephone:

eMail: eMail:

SIBLINGS

Name Date of Birth School Attended

EMERGENCY CONTACTS (Please list in the order you would like us to contact them)

Name Home Telephone Mobile Telephone Relation to child

OFFICE USE ONLY

UPN

DOA

Teacher 3 4 5 6

MEDICAL INFORMATION

Doctor:

Surgery Address:

Telephone Number:

Please advise us of any medical conditions—allergies, asthma, eczema, sight or hearing problems etc.

Policy on Parental use of Social Networking and Internet Sites

Overview:

Social networking sites such as Facebook and Twitter are now widely used. This type of media allows people to communicate in ways that

were not previously possible. However, such sites can be inappropriately used by some as a means of expressing negative or offensive

views about schools and their staff. This document sets out this School’s approach to parental use of such sites and sets out the

procedures we will follow and action we may take when we consider that parents have used such facilities inappropriately. When we

have referred to “parent” in this document, we also include carers, relatives or anyone associated with the School. Objectives

The purpose of this policy is to:

• Encourage social networking sites to be used in a beneficial and positive way by parents;

• Safeguard pupils, staff and anyone associated with the school from the negative effects of social networking sites;

• Safeguard the reputation of the School from unwarranted abuse on social networking sites;

• Clarify what the School considers to be appropriate and inappropriate use of social networking sites by parents;

• Set out the procedures the School will follow where it considers parents have inappropriately or unlawfully used social networking sites

to the detriment of the School, its staff or its pupils, and anyone else associated with the School; and

• Set out the action the School will consider taking if parents make inappropriate use of social networking sites.

Appropriate use of social networking sites by parents Social networking sites have potential to enhance the learning and achievement of

pupils and enable parents to access information about the School and provide feedback efficiently and easily. In addition, the School

recognises that many parents and other family members will have personal social networking accounts, which they might use to discuss/

share views about school issues with friends and acquaintances. As a guide, individuals should consider the following prior to posting any

information on social networking sites about the School, its staff, its pupils, or anyone else associated with the School:

• Is the social networking site the appropriate channel to raise concerns, give this feedback or express these views?

• Would private and confidential discussions with the School be more appropriate? e.g. if there are serious allegations being made/

concerns being raised. Social media/internet sites should not be used to name individuals and make abusive comments about those

people. Please contact the school to discuss any concerns you may have.

• Are such comments likely to cause emotional or reputational harm to individuals which would not be justified, particularly if the School

has not yet had a chance to investigate a complaint?

•The reputational impact that the posting of such material may have to the School; any detrimental harm that the School may suffer as a

result of the posting; and the impact that such a posting may have on pupils’ learning. Inappropriate use of social networking sites by

parents Although social networking sites may appear to be the quickest and easiest way to express frustrations or concerns about the

School (and those associated with it), it is rarely appropriate to do so. Other channels, such as a private and confidential discussion with

the School, or using the School’s formal complaints process are much better suited to this. The School considers the following examples

to be inappropriate uses of social networking sites. (This list is non-exhaustive and intended to provide examples only):

• Making allegations about staff or pupils at the School/cyber-bullying;

• Making complaints about the School/staff at the School;

• Making defamatory statements about the School or staff at the School;

• Posting negative/offensive comments about specific pupils/staff at the School;

• Posting racist comments;

• Posting comments which threaten violence.

Parents should also ensure that their children are not using social networking/internet sites in an inappropriate manner. It is expected

that parents/carers explain to their children what is acceptable to post online. Parents/carers are also expected to monitor their

children’s online activity, including in relation to their use of social media. Procedure the School will follow if inappropriate use continues

The School will always try to deal with concerns raised by parents in a professional and appropriate manner and understands that

parents may not always realise when they have used social networking sites inappropriately. Therefore, as a first step, the School will

usually discuss the matter with the parent to try and resolve the matter and to ask that the relevant information be removed from the

social networking site in question. If the parent refuses to do this and continues to use social networking sites in a manner the School

considers inappropriate, the School will consider taking the following action:

• Take legal advice and/or legal action where the information posted is defamatory in any way or if the circumstances warrant this;

• Set out the School’s concerns to you in writing, giving you a warning and requesting that the material in question is removed;

• Contact the Police where the School feels it appropriate – for example, if it considers a crime (such as harassment) has been

committed; or in cases where the posting has a racial element, is considered to be grossly obscene or is threatening violence;

• Contact the host/provider of the Social Networking site to complain about the content of the site and ask for removal of the

information;

• Take other legal action against the individual.

LUNCHTIME ARRANGEMENTS

Lunchtime Arrangements 12:20 to 13:20

School meals must be paid for in advance half termly. Cheques should be payable to Hertfordshire Catering Ltd (HCL)

If you think your child may be eligible for Free School Meals please apply online: www.hertsdirect.org/freeschoolmeals Telephone: 0300 123 4048

Special Dietary Needs (e.g. Vegetarian, Allergies):

Lunchtime Arrangements: Paid School Meal ⃝ Sandwiches from Home ⃝ Going Home for Lunch ⃝ Free School Meal

ETHNICITY AND LANGUAGE

Please study the list below and tick one box only to indicate the ethnic background of your child

(a) White (b) Mixed

British ⃝ White and Black Caribbean ⃝

Irish ⃝ White and Black African ⃝

Traveller from Irish heritage ⃝ White and Asian ⃝

Gypsy/Roma ⃝ Any other mixed background ⃝

Any other White background ⃝

Italian ⃝

Turkish ⃝

(c) Asian or Asian British (d) Black or Black British

Indian ⃝ Caribbean ⃝

Pakistani ⃝ African ⃝

Bangladeshi ⃝ Any other Black background ⃝

Any other Asian background ⃝

(e) Chinese ⃝ (f) Any Other Ethnic Group ⃝

I do not wish an ethnic background to be recorded ⃝

Please indicate the home language of your child:

Please indicate the first language of your child:

Please indicate if they have English as an additional language:

RELIGION

Muslim ⃝ Christian ⃝ Sikh ⃝ Buddhist ⃝

Jewish ⃝ Hindu ⃝ No Religion ⃝ Other ⃝

I do not wish a religion to be recorded ⃝

PREVIOUS SCHOOLS ATTENDED

Name Address From To

OTHER INFORMATION

Is there any other information we ought to know about your child or family?

Does your child have any special needs of which we should be aware?

Is there anyone with whom your child should not be allowed to leave the school?

PARENTAL PERMISSION

From time to time we might put photographs of your child, in class or group activities, on our website or Twitter

feed. We never publish children’s names with photographs, we assume permission to do this unless you inform

us in writing.

I have read and understood the Primary Pupil Acceptable Use Agreement/eSafety Rules and give

permission for my child to use the internet at school (see below)

Yes ⃝ No ⃝

I have read and understood the Parent Acceptable Use of Social Media (see overleaf) Yes ⃝ No ⃝

I give consent for Local Visits and Off-Site Activities Yes ⃝ No ⃝

I give my consent for my eMail address and mobile number to be given to our external provider to

enable the school to contact me by eMail and text message

Yes ⃝ No ⃝

I give permission for the school to administer routine and emergency first aid medical treatment if Yes ⃝ No ⃝

Primary Pupil Acceptable Use Agreement / eSafety Rules

I will only use school IT equipment for activities agreed by school staff.

I will not use my personal email address or other personal accounts in school when doing school work.

I will not sign up for any online service on school devices unless this is an agreed part of a school project approved by my teacher and agreed by my parent/carer.

I will only open email attachments if it has been approved by a member of school staff in school or a parent/carer out of school.

In school I will only open or delete my files when told by a member of staff.

I will not tell anyone other than my parents/carers my passwords. I will not use other people’s usernames or passwords to pretend to be them online.

I will make sure that all online contact I make is responsible, polite and sensible. I will be kind and respectful at all times.

If I come across anything upsetting, unpleasant or nasty, or anything that makes me feel unsafe, I will tell my teacher or my parent/carer immediately.

If someone says, asks or posts about me anything upsetting, unpleasant or nasty, or anything that makes me feel unsafe, I will not reply. I will tell my teacher or my parent/carer immediately.

I will not give out my own or other people’s personal information, including: name, phone number, home address, interests, schools or clubs. I will tell my teacher or parent/carer if anyone asks me online for personal information.

Uploading or sending my image (photographs, videos, live streaming) online puts me at risk. I will always seek permission from my teacher or parent/carer if I wish to do this. I will not take, share or upload any image of anyone else without their permission and also, if they are a child, without their parent’s/carer’s permission.

Even if I have permission, I will not upload any images, videos, sounds or words that could upset, now or in the future, any member of the school community, as this is cyberbullying.

I understand that some people on the internet are not who they say they are and some people are not safe to be in contact with. I will not arrange to meet someone I only know on the internet. If someone asks to meet me, I will not reply to them and I will tell a teacher or a parent/carer immediately.

I understand that everything I do or receive online can be traced now and in the future. I know it is important to build a good online reputation.

I understand that some personal devices are allowed in school and some are not, and I will follow the rules. I will not assume that new devices can be brought into school without getting permission.

I will not lie about my age in order to access games, apps or social networks that are for older people as this will put me at risk.

I understand that these rules are designed to keep me safe now and in the future. If I break the rules my teachers will look into it and may need to take action.

Taken from Appendix D—Online Safety Policy (This can be found on the School’s Website)

Signature of Parent or Legal Guardian:

Name (please print):

Date:

Data Protection: In accordance with General Data Protection Regulations and the

current Data Protection Act, the school has a duty to protect this information and to

keep it up to date. The school is required to share some of the data with the Local

Authority and with the DfE. For further information, please refer to the privacy notice

on the school’s website.