Reception 2021 Data Collection Information
Please complete this data collection form to enable school to have a record of your contact information. By submitting this form you are informing St James' Primary School of your contact information and are agreeing that the information provided is current and accurate on the date submitted. In the 'Medical conditions' section of this form, if your child has a known medical condition, you must complete the separate medical conditions google form.
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Email *
Child Full Name *
Chosen name
Gender *
Child's date of birth ../../.... *
Child address (including post code) *
Name(s) of sibling(s) in school including Class/Year
CONTACT No.1 Contact Information
Complete this section with the contact information of the person who you wish to be the first priority contact.
Contact 1 - Title *
Contact 1 - Full Name *
Contact 1 - Address (including post code) *
Address if different to child address
Contact 1 - Relationship to child *
Relationship to child
Contact 1 - Home/Daytime telephone number *
Contact 1 - Mobile number *
Contact 1 - Work number
Contact 1 - Email *
Contact 1 - Parental Responsibility *
CONTACT No.2 Contact Information
Complete this section with the contact information of the person who you wish to be the second priority contact.
Contact 2 - Title
Clear selection
Contact 2 - Full Name
Contact 2 - Address (including post code)
Clear selection
Address if different to child address
Contact 2 - Relationship to child
Clear selection
Relationship to child
Contact 2 - Home/Daytime telephone number
Contact 2 - Mobile number
Contact 2 - Work number
Contact 2 - Email
Contact 2 - Parental Responsibility
Clear selection
CONTACT No.3 Contact Information
Complete this section with the contact information of the person who you wish to be the third priority contact.
Contact 3 - Title
Clear selection
Contact 3 - Full Name
Contact 3 - Address (including post code)
Clear selection
Address if different to child address
Contact 3 - Relationship to child
Clear selection
Relationship to child
Contact 3 - Home/Daytime telephone number
Contact 3 - Mobile number
Contact 3 - Work number
Contact 3 - Email
Contact 3 - Parental Responsibility
Clear selection
Is your family currently in receipt of: Tick the box(es) that apply *
Required
Has your child been adopted from care or currently placed with you under guardianship/foster care *
Meal Arrangements - Tick the relevant box(es) that apply *
Required
Other meal arrangement
Any other information regarding dietary needs
MEDICAL INFORMATION
Does your child have a medical condition (this includes any allergies/intolerance's)? If you answer 'Yes' to this question you must complete the medical conditions form, the link for the form https://forms.gle/sVCyjmBDMNPpxXZcA *
GP Name *
Medical Practice - Address and Telephone number *
Educational History
Name(s) and Address(es) of previous school(s), include date of admission/leaving
Ethnicity *
Religion *
Home Language *
First Language *
Other Language(s) *
Country of Birth *
Nationality *
School Visits-I agree to my child taking part in school activities which involve local visits out of school *
Photographs - I agree for my child's photograph being used-Tick box(es) that apply *
Required
Home/School Agreement - Read the information and respond whether you agree/disagree in the next section
I accept the responsibility as a parent to help my child:
Ensure that my child attends school regularly and is brought and collected on time
Give reason for any absence on the first day by telephone and follow up with a letter on their return
Ensure that my child is properly equipped and all uniform/PE kit is labelled
Encourage my child to do their best and praise effort and achievement
Encourage my child to be well behaved and have respect for all staff and pupils in school
Home/School Agreement *
Data Protection Act 1998: The school is registered under the Data Protection Act for holding personal data. 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 DfES.
Parent Name: *
Date ../../.... *
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