Bassett House School
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Bassett House School Bassett House School
  • About
    • About
    • Head’s welcome
    • Uniquely Bassett House
    • Academic success
    • Facilities
    • Reviews and reports
    • Our staff
    • Governance
    • Policies
    • Visit us
  • Early Years 3-5 years
    • Early Years 3-5 years
    • Teaching Philosophy
    • Montessori Approach
    • The Bassett Bear House Curriculum
    • Seven Areas of Learning
    • Reading & writing
    • Outdoor Learning
    • Apply for a place
  • Prep 5–11 years
    • Prep 5–11 years
    • Teaching philosophy
    • Curriculum
    • Academic success
    • 11+ & Destination Schools
    • Continuous Provision
    • Apply for a place
  • Enrichment
    • Enrichment
    • Performing & creative arts
    • Physical education & sport
    • Clubs
    • Trips
    • Apply for a place
  • Admissions
    • Admissions
    • How to join
    • Make an enquiry
    • Apply for a place
    • Fees
    • Visit us
    • Attend a Stay and Play
    • Book an Open Day
    • Download a prospectus
    • Apply for a place
  • School life
    • School life
    • Pastoral care
    • Term dates
    • School day
    • Uniform
    • Parents’ role
    • Healthy Eating
    • ICT provision
    • Apply for a place
  • News
    • News
    • Latest news
    • Apply for a place
  • Contact

Key Information Data Capture

"*" indicates required fields

1Your details
2Child's details
3Emergency Contacts
4Health & Diet
5Photo consent
Who's filling in this form?*
Child's name*
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Emergency Contact Information

Emergency Contact 1: Name*
Emergency Contact 2: Name*

Health and Diet

Immunisations*
Please select all immunisations your child has had. If your child has not had one of these immunisations or completed the course (if relevant), please let the school office know if and when your child is immunised.
DD slash MM slash YYYY
DD slash MM slash YYYY
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Please tick if your child has had any of the following:*
Does your child suffer from any of the following? If the answer to any of the below is Yes, please select and give full details below.*
Do you give consent for your child to be given prescribed medication by staff at Bassett House, eg: inhalers if required?*
Is your child allergic to plasters or antiseptic wipes?*
(Unless the school has been informed that your child is allergic to either plasters or antiseptics, if an accident should occur the wound will be cleaned with water and/or an antiseptic wipe and a plaster applied if necessary.)
Has your child been prescribed an epipen?*
Please note that the school requires two epipens for any child for whom an epipen has been prescribed – one to be kept in the school office and the other to be kept in the child’s classroom.
Does your child adhere to a specific diet for health or religious beliefs eg. vegetarian, vegan, halal, kosher etc?*
Does your child have any allergies, or medical or other needs in terms of their diet?*
If so, please state them here. Any such dietary requirement must have been recommended by a medical doctor or be due to religion or belief (as protected by law).

Photo consent

I consent to my child being featured in photo and video content to be shared on the school's website, social media and in marketing materials for Bassett House and Dukes Education Group during my child's time at the school and for up to two years after leaving.*

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Bassett House School
60 Bassett Road
London W10 6JP
020 8969 0313 info@bassetths.org.uk
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Together we're extraordinary.

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Together we're extraordinary.

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