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Pupil Registration Form 2021 (complete by 4.5.21)

All schools are required by law to keep on record details of children admitted; we should therefore be grateful if you would complete this form and submit by Tuesday 4th May 2021.

By submitting this form you are consenting to all of the information being stored at Hiltingbury Junior School.

Any consent given will be valid for the period your child is a pupil at Hiltingbury Junior School. You can withdraw consent at any time by emailing

Please note that this form does not automatically save, so please allow time to complete all questions before submitting.

Pupil Details


Address Details

If the child’s residence at the present address (whether living with parents or any other person) is not permanent please state the reason and probable duration of the stay, and give the name and address of the person with whom the child normally resides.


Please provide 2 named contacts and a minimum of 3 contact telephone numbers in case of emergency.
For safeguarding purposes we are unable to accept less than 2 named contacts.

Contact 1

Priority to contact in an emergency*
Parental Responsibility*

Contact 2

Priority to contact in an emergency*
Parental Responsibility*

Parental responsibility may be shared between a number of people beyond the child’s natural parents. Married parents have equal parental responsibility; on separation or divorce both parents continue to have responsibility. In such circumstances the school will forward copies of school reports etc to the separated parent if requested.

I will email copies of any court orders relating to my child to -
Is the child adopted, ever been a looked after child or resident with foster parents.


Are there any medical needs the school should be aware of.*
If your child uses an inhaler, is it carried on their person?
Have any of the below services been involved with your child?*

Ethnic/Cultural Information


Please complete the following; this will help us to see how well children from different groups are doing. We want to make sure that all children are treated fairly and do well at school.



Select one of the following*

Travel Arrangements

Please select main choice only*

Using images of children

Occasionally, we may take photographs of the children at our school. We may use these images in our schools prospectus or in other printed publications that we produce, as well as on our website or on project display boards at our school. We may also make video or webcam recordings for school-to-school conferences, monitoring or other educational use.

From time to time, our school may be visited by the media who will take photographs or film footage of a visiting dignitary or other high profile event. Pupils will often appear in these images, which may appear in local or national newspapers, or on televised news programmes.

To comply with data protection legislation, we need your permission before we can photograph or make any recordings of your child. Please answer questions 1 to 5 below, then sign and date the form where shown.

The information you provide (address, contact numbers) will be securely stored and used in accordance with our GDPR policy and not be used for any other purpose than confirming your permission to use the material.

1. May we use your child’s photograph in printed publications that we produce for promotional purposes or on project display boards?*
2. May we use your child’s image on our website?*
3. Do you give consent for your child to be photographed individually or as a whole year group by the school photographer(consent can be withdrawn at any time).*
4. May we record/stream your child’s image on video or webcam? Eg. Live home learning, school celebration assemblies, and streamed performances*
5. Are you happy for your child to appear in the media*
6. Are you happy for your child to appear on Social Media sites used by the school e.g. Twitter and Facebook - Please note that once images are uploaded, they will be subject to the terms and conditions of the social media site. Neither you nor the school will have control over how those images are further used, amended or reproduced, either by the site or by the public. Please note that websites can be viewed throughout the world and not just in the United Kingdom where UK law applies.*


1. This consent is valid for five years from the date of submission, or for the period of time your child attends this school. The consent will automatically expire after this time.
2. We will not re-use any photographs or recordings after your child leaves this school without prior consent.
3. We will not use the personal details or full names (which means first name and surname) of any child or adult in a photographic image on video, on our website, in our school prospectus or in any of our other printed publications without prior consent.
4. If we name a pupil in the text, we will not use a photograph of that child to accompany the article without prior consent (See point 3 above.)
5. We will not include personal contact details on our website, in our school prospectus or in other printed publications.
6. We may include pictures of pupils and teachers that have been drawn by the pupils.
7. Your consent can be withdrawn at any time in writing.

Please note that the press have some exemptions from data protection legislation and may want to include the names and personal details of children and adults in the media.

Home School Agreement

I have read and understood the conditions of use and give my consent for my child’s image/s to be used as described above*

1. The Parents I/We shall try to:
*see that my child goes to school regularly, on time and properly equipped;
*let the school know about any concerns or problems that might affect my child’s work or behaviour
*support the school’s policies and guidelines for behaviour;
*support my child in homework and other opportunities for home learning;
*attend parents’ evening and discussions about my child’s progress;
*get to know about my child’s life at the school.

2. The School will
*contact parents if there is a problem with attendance, punctuality or equipment;
*provide a secure and supportive environment for all children;
*let parents know about any concerns or problems that affect their child’s work or behaviour;
*set, mark and monitor homework, and encourage children to participate in our homework programme;
*arrange parent’s evenings during which progress will be discussed, and provide parents with an Annual Report;
*keep parents informed about school activities through regular letters home, news sheets and notices about special events.

I confirm that we have read and will abide by the Home School Agreement*