New Pupil Registration Form - In Year Applications

Green Lanes Primary School Registration Form

Green Lanes, Hatfield, AL10 9JY

Tel: 01707 262556

Email: admin@greenlanes.herts.sch.uk

Website: www.greenlanes.herts.sch.uk

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* 1. Child's first name

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* 2. Child's middle name

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* 3. Child's surname

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* 4. Preferred First Name (Is your child known by another name?)

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* 5. Preferred Surname (if different from LEGAL Surname)

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* 6. Gender

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* 7. Date of birth

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* 8. Country of birth

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* 9. Please upload a copy of your child's full birth certificate and/or current passport.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 10. Ethnicity

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* 11. Ethnicity

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* 12. Nationality

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* 13. Religion

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* 14. Home Address including town and postcode (child's main place of residence)

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* 15. Second Address (shared parenting)

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* 16. Primary Parent 1: First Name and Surname

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* 17. Primary Parent 1: Title

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* 18. Primary Parent 1: Relationship to Child

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* 19. Primary Parent 1: Parental Responsibility?

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* 20. Primary Parent 1: Contact Telephone Numbers

Home

Work

Mobile

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* 21. Primary Parent 1: Email address

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* 22. Primary Parent 2: First Name and Surname

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* 23. Primary Parent 2: Title

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* 24. Primary Parent 2: Relationship to Child

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* 25. Primary Parent 2: Parental Responsibility?

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* 26. Primary Parent 2: Contact Telephone Numbers

Home

Work

Mobile

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* 27. Primary Parent 2: Address (if different to child)

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* 28. Primary Parent 2: Email address

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* 29. Emergency Contact 1: Please provide at least one emergency contact who we can contact in case of emergency where we are unable to get hold of you. This should be someone other than yourself.

Name

Contact Number

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* 30. Emergency Contact 2:

Name

Contact Number

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* 31. I give permission for the following adults to collect my child from school in my absence

Full Name and relationship to child:

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* 32. If you have given someone else permission to collect your child from school please provide a security password for them to use on collection - please make sure you give them this password.

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* 33. I give permission for my child to walk home from school (only applicable to Year 5 and Year 6 pupils)

Yes

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* 34. Home Language (this is the main language your child speaks at home)

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* 35. Other Language - please specify

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* 36. Is English an Additional Language?

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* 37. English Proficiency (please tick those applicable)

My child can read English

My child can write English

My child understands spoken English

We speak English in our home

My child is fluent is English

My child is developing their English

My child is new to English

My child has no English

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* 38. Are you eligible for benefit related Free School Meals? If you receive certain benefits you may be eligible for benefit related FSM.
For further information and to apply visit Apply for Free School Meals

Yes

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* 39. If you would like the school to make a FSM application on your behalf please provide us with your Full Name, DOB, and NI Number. By giving us this information you are giving permission for the school to make an online application with Hertfordshire County Council. The school will be notified if you are or are not eligible. In some circumstances, HCC may require further information relating to the benefits you receive and therefore will contact you directly.

Full Name

Date of Birth

National Insurance Number

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* 40. Children in Public Care: Is your child looked after, or was previously looked after and is now adopted, or with a child arrangement or special guardianship order?

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* 41. At risk: Is your child or a sibling of your child subject to an inter-agency child protection plan and has been placed on the Child Protection Register?

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* 42. Does your child have an Educational Health Care Plan (EHCP)

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* 43. Please list any diagnosed medical conditions (e.g. ASD / ADHD / Asthma / Diabetes etc). If your child has a diagnosis please forward us any relevant medical documents. It may be necessary for you to meet with the school to discuss a Health Care Plan for your child.

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* 44. Does your child take any regular medication? Please give details of medication, dosage and frequency.

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* 45. Does your child have an EpiPen or similar for severe allergies?

Yes

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* 46. Does your child have an inhaler?

Yes

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* 47. Which GP surgery is your child registered at?

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* 48. Will your child eat school dinners, packed lunch or mixture of both?

School dinners

Packed lunches

Both

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* 49. Does your child have any food allergies or intolerances? Please give us the details of these allergies/intolerances.

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* 50. Dietary requirements: If your child has allergies, intolerance or religious preferences you will need to apply for a Special Menu with Hertfordshire Catering Limited. To apply please visit Herts Catering Limited. We are a NUT FREE school therefore nuts in any form or products containing nuts are banned.

My child has no specific dietary requirements

My child is vegetarian

My child cannot eat Pork

My child cannot eat Beef

My child cannot have diary products

My child is gluten free

My child is allergic to Egg

My child is Halal (please note we do not offer Halal therefore your child would need to choose the vegetarian option on the school dinner menu)

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* 51. If your child has a sibling or siblings at Green Lanes School, please give their name/s.

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* 52. How will your child travel to school?

Walk

Car

Bus

Cycle

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* 53. Please provide details of any previous/current schools or nursery schools.

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* 54. Parent Consent - Images: I give consent for my child's image to be taken.

Yes

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* 55. If you have answered YES to the question above please specify in detail which permissions you give.

Individual and/or group photos (Photographs to be used within the school on school displays, school newsletters etc).

Individual and/or group photos or videos to be uploaded on the class Google Classroom. Please note these images will be seen by other parents of the class.

Individual and/or group photo to be published in the local media such as Welwyn Hatfield Times (these are usually group photos including First Class Supplement, Nativities, School Plays, Sports Achievements etc.)

Individual and/or group photos to be published on the school's website or school prospectus.

I give permission for my child to be included in film imagery (videos) to be uploaded onto the school website.

I give permission for my child to be included in videos for internal use only.

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* 56. Other Parental Consents: Please tick all that applicable options.

I give permission for my child to leave the school grounds to take part in educational trips and local walks around the area.

I give permission for the school to act as 'Local Parentis' in cases of severe illness or emergency if the school is not able to get in contact with me (e.g. calling 999)

I give permission for my child to receive emergency medical treatment pending my arrival.

I give permission for my child to be given First Aid treatment.

I give permission for my child to walk home from school independently (For Year 5 and 6 Children ONLY).

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* 57. At Green Lanes Primary School, we use G Suite for Education, and we are seeking your permission to provide and manage a G Suite for Education account for your child. G Suite for Education is a set of education productivity tools from Google including Gmail, Calendar, Docs, Classroom, and more used by tens of millions of students and teachers around the world.

At Green Lanes Primary School, students will use their G Suite accounts to complete assignments, communicate with their teachers, and learn 21st century digital citizenship skills.

The notice, Google Classroom at Green Lanes (available on the school website) provides answers to common questions about what Google can and can’t do with your child’s personal information, including:
• What personal information does Google collect?
• How does Google use this information?
• Will Google disclose my child’s personal information?
• Does Google use student personal information for users in K-12 schools to target advertising?
• Can my child share information with others using the G Suite for Education account?

Please read it carefully, let us know of any questions, and then sign below to indicate that you’ve read the notice and give your consent. If you don’t provide your consent, we will not create a G Suite for Education account for your child. Should you not wish for an account to be created the school will do our best to help you access work and homework for you child. The School office will help you with this.

For more information click here

I give permission for Green Lanes Primary School to create/maintain a G Suite for Education account for my child and for Google to collect, use, and disclose information about my child only for the purposes described in the notice.

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* 58. Is there any other information about your child that you would like to share with the school or feel the school should know?

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* 59. Declaration: The information I have given on this form is complete and accurate. I understand that my personal information will be held securely and will be used only for local authority purposes. The school will not use the data for any other purpose, nor will the school share your data with any third parties other than the Department of Education (for statutory reporting), Hertfordshire County Council Departments and Educational Services that are relevant and/or a benefit to your child, and assisting families to access the services that children are entitled to (i.e. Free School Meals). I agree to Green Lanes School using my information (DOB and NI number) to consider an application for Free School Meals.

Agree

Disagree

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* 60. Data Protection: In accordance with General Data Protection Regulation, the school has a duty to protect this information and keep it up to date. The school is required to share some of the data with the Local Authority, NHS and DfE. I confirm I have read the School's Privacy Notice Green Lanes School Privacy Notice.

New Pupil Registration Form - In Year Applications

Green Lanes Primary School Registration Form

Question Title

* 1. Child's first name

Question Title

* 2. Child's middle name

Question Title

* 3. Child's surname

Question Title

* 4. Preferred First Name (Is your child known by another name?)

Question Title

* 5. Preferred Surname (if different from LEGAL Surname)

Question Title

* 6. Gender

Question Title

* 7. Date of birth

Question Title

* 8. Country of birth

Question Title

* 9. Please upload a copy of your child's full birth certificate and/or current passport.

Question Title

* 10. Ethnicity

Question Title

* 11. Ethnicity

Question Title

* 12. Nationality

Question Title

* 13. Religion

Question Title

* 14. Home Address including town and postcode (child's main place of residence)

Question Title

* 15. Second Address (shared parenting)

Question Title

* 16. Primary Parent 1: First Name and Surname

Question Title

* 17. Primary Parent 1: Title

Question Title

* 18. Primary Parent 1: Relationship to Child

Question Title

* 19. Primary Parent 1: Parental Responsibility?

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* 20. Primary Parent 1: Contact Telephone Numbers

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* 21. Primary Parent 1: Email address

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* 22. Primary Parent 2: First Name and Surname

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* 23. Primary Parent 2: Title

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* 24. Primary Parent 2: Relationship to Child

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* 25. Primary Parent 2: Parental Responsibility?

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* 26. Primary Parent 2: Contact Telephone Numbers

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* 27. Primary Parent 2: Address (if different to child)

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* 28. Primary Parent 2: Email address

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* 29. Emergency Contact 1: Please provide at least one emergency contact who we can contact in case of emergency where we are unable to get hold of you. This should be someone other than yourself.

Question Title

* 30. Emergency Contact 2:

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* 31. I give permission for the following adults to collect my child from school in my absence

Question Title

* 32. If you have given someone else permission to collect your child from school please provide a security password for them to use on collection - please make sure you give them this password.

Question Title

* 33. I give permission for my child to walk home from school (only applicable to Year 5 and Year 6 pupils)

Question Title

* 34. Home Language (this is the main language your child speaks at home)

Question Title

* 35. Other Language - please specify

Question Title

* 36. Is English an Additional Language?

Question Title

* 37. English Proficiency (please tick those applicable)

Question Title

* 38. Are you eligible for benefit related Free School Meals? If you receive certain benefits you may be eligible for benefit related FSM. For further information and to apply visit Apply for Free School Meals

Question Title

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* 38. Are you eligible for benefit related Free School Meals? If you receive certain benefits you may be eligible for benefit related FSM.
For further information and to apply visit Apply for Free School Meals