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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
Join our Open Morning
Download a prospectus
Apply for a place
School life
School life
Pastoral care
Term dates
School day
Uniform
Events Calendar
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
1
Your details
2
Child's details
3
Emergency Contacts
4
Health & Diet
5
Photo consent
Who's filling in this form?
*
First
Last
Relationship
*
Mother
Father
Step-Mother
Step-Father
Nanny
Sibling
Aunt
Uncle
Neighbour
Grandparent
Guardian
Family friend
Au Pair
Personal/Executive Assistant
Child's name
*
First
Last
Date of birth
DD slash MM slash YYYY
Year group
*
Preschool
Reception
Form 1
Form 2
Form 3
Form 4
Form 5
Form 6
Emergency Contact Information
Emergency Contact 1: Name
*
First
Last
Relationship
*
Mother
Father
Step-Mother
Step-Father
Nanny
Sibling
Aunt
Uncle
Neighbour
Grandparent
Guardian
Family friend
Au Pair
Personal/Executive Assistant
Email
*
Phone
*
Notes
Emergency Contact 2: Name
*
First
Last
Relationship
*
Mother
Father
Step-Mother
Step-Father
Nanny
Sibling
Aunt
Uncle
Neighbour
Grandparent
Guardian
Family friend
Au Pair
Personal/Executive Assistant
Email
*
Phone
*
Notes
Health and Diet
Immunisations
*
Diphtheria
Tetanus
Polio
Whooping cough
MMR x 2
Meningitis C
None of the above
Select All
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.
Immunisation Date: Diptheria
DD slash MM slash YYYY
Immunisation Date: Tetanus
DD slash MM slash YYYY
Immunisation Date: Polio
DD slash MM slash YYYY
Immunisation Date: Whooping Cough
DD slash MM slash YYYY
Immunisation Date: MMR (First dose)
DD slash MM slash YYYY
Immunisation Date: MMR (Second dose)
DD slash MM slash YYYY
Immunisation Date: Meningitis C
DD slash MM slash YYYY
Please tick if your child has had any of the following:
*
None of the below
Mumps
Measles
German measles
Chicken pox
Whooping cough
Scarlet Fever
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.
*
None of the below
Asthma
Hay fever
Eczema
Allergies (food, bites, antibiotics, anti-histamine, suncream)
Epilepsy / fits / convulsions
Serious illness or operation
Diabetes
Details
Do you give consent for your child to be given prescribed medication by staff at Bassett House, eg: inhalers if required?
*
Yes
No
Is your child allergic to plasters or antiseptic wipes?
*
Yes
No
(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?
*
Yes
No
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.
Please note below any current serious health conditions of which the school should be aware.
Does your child adhere to a specific diet for health or religious beliefs eg. vegetarian, vegan, halal, kosher etc?
*
Yes
No
Does your child have any allergies, or medical or other needs in terms of their diet?
*
Yes
No
If you answered yes, please give details below.
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.
*
I consent
I do not consent
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Saturday 12 October 2024
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