Student Data Collection Pack 2020-2021 - IMPORTANT NOTICE: Please fill in this form with your child's details and return to the Academy ASAP ...
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Student Data
Collection Pack
2020-2021
Student Name:
IMPORTANT NOTICE:
Please fill in this form with your
child’s details and return to the
Academy ASAP.
Personal Student Information Sheet 2020-2021
Please complete this form giving all relevant details. It will be referred to during
the school day and if your son/daughter participates in either an off-site visit
or local evening event/activity.
Please inform the Academy if your child’s contact details change.
Student’s details only
Legal Forename of student
Legal Middle Names(s)
Legal Surname of student
Preferred Forename/Surname
Date of Birth Gender
Home Address
Parent/Carer Details Priority 1
Forename
Surname
Parental Responsibility Relationship to student
YES NO
Contact Telephone Numbers Email Address (please write clearly)
Home:.................................................
NOTE: The mobile number and email address provided for
Mobile:................................................
Parent/Carer (Priority1) will be used to inform you, via text/
Work:.................................................. email, of Academy events and general Academy information.
Home Address (if different from students)
Parent/Carer Details Priority 2
Forename
Surname
Parental Responsibility Relationship to student
YES NO
Contact Telephone Numbers Email address (please write clearly)
Home:.................................................
Mobile:................................................
Work:..................................................
Home Address (if different from students)
Alternative Contact
Full Name
Relationship to student
Contact Telephone Numbers Home Address
Home:.................................................
Mobile:................................................
Work:..................................................
Alternative Contact
Full Name
Relationship to student
Contact Telephone Numbers Home Address
Home:.................................................
Mobile:................................................
Work:..................................................
Student Characteristics - Ethnicity Details
Please read the list below and tick one box to indicate your child’s ethnic origin
White British White Irish White Eastern European
Black Caribbean Black African White & Black Caribbean
Indian Pakistani Bangladeshi
Chinese White & Chinese White & Asian
Any other
Yemini Gypsy/Romany white background
Any other Any other Any other
black background mixed background ethnic background
First Language Main Language (spoken at home)
Travel Arrangements
Please tick one box : which transport/travel arrangment is your child most likely to
use/take?
Car or Van Car Share Cycle
Taxi Walk Bus
Other (please state)
Children of Service Personnel
If your child has a parent who is service personnel
serving in the regular HM Forces Military Units in the
Armed Forces, please tick this box.
The information requested on this form is subject to the provisions of the ACET
Privacy Notice. The information will only be disclosed to the Local Education
Authority, the health and welfare agencies or where a law or emergency
necessitates a disclosure.Medical Information
Doctor’s Name Medical Surgery Address
Medical Surgery Telephone Number
Any special dietary requirements? YES NO
Has your child suffered from any of the following (if yes please give details below)
Asthma or bronchitis YES NO
Heart condition YES NO
Fits, fainting or blackouts YES NO
Severe headaches or migraine YES NO
Allergies to any known drug YES NO
Other allergies eg food, materials YES NO
Other illnesses or disability not named YES NO
If yes to any of the above please give details
Is your child currently vaccinated against tetanus? YES NO
Date of injection: / / Date of booster: / /
Does your child require medication(s) during the
YES NO
school day or on an offsite visit/activity?
If YES, we will provide you with the “medication in school” document.
Should your child require medication in the future this form is available via the student website.Medical Information & External Visits
Is your child receiving medical or surgical
treatment from your family doctor or hospital and/ YES NO
or have been given specific advice to follow in
emergencies?
If YES, Please give details
Does your child have any mobility, visual and/or
YES NO
hearing difficulties?
If YES, Please give details
Accident/Illness
I consent to my child receiving medication as instructed and any emergency dental,
medical or surgical treatment, including inoculations, general or local anaesthetic,
surgery or blood transfusion; as considered necessary by the medical authorities
present.
Please tick as appropriate: I give consent I do not give consent
Swimming ability and water confidence
Please tick which box best describes your child’s swimming ability.
Strong Swimmer Able Swimmer
Weak Swimmer Can’t Swim
Is your child water confident with regard to
YES NO
activities in or near water?
I agree to my child attending educational visits and activities during the academic
year and I acknowledge that to be included he/she will need to maintain responsible
behaviour.
I declare that I have answered all the above questions to the best of my ability and
have not knowingly withheld any information regarding physical fitness.
I undertake to inform the school of any changes to the above
Please tick as appropriate: I give consent I do not give consentConsent for academy trips and other off-site activities
Please read the following important information before signing to give your
consent for your child to participate in academy trips and other off-site
activities.
The trips and activities covered by this consent include:
• all visits (including residential trips) which take place during the holidays or a weekend;
• adventure activities at any time;
• off-site sporting fixtures outside the academy day;
The academy will send you information about each trip or activity before it takes place. you
can, if you wish, tell the academy that your child does not want to take part in any particular
trip or activity.
Written consent will not be requested from you for the majority of off-site activities offered by
the academy - for example, year group vistits to local amenities; as such activities are part of
the academy’s curriculum and usually take place during the usual academy day.
Residential Visits
For residential trips, please inform the academy if your child has been in contact with any
contagious or infectious diseases or suffered from any illness/injury in the last four weeks
prior to the trip/activity that may be contagious/infectious/active.
Updating contact details
Before commencement of any trip/activity, please inform the academy/trip organiser, if your
child’s medical, dietary or contact details have changed
Behaviour
If a student’s behaviour or attendance is below the Academy’s expectations they will not
be offered a place on a trip. The Academy reserves the right to refuse students from going
on trips if their behaviour or attendance is not acceptable or deteriorates prior to the trip.
Students who are not able to go on the trip because of these reasons will forfeit any trip
costs paid which the Academy is unable to recover from the trip operators. Whilst on the trip,
students must adhere to the Academy’s Offsite Visits policy.
Trip payment
Trips can be paid for via Schoolcomms; which can be accessed online at
www.schoolcomms.com or by downloading the app.
All payments must be made by the deadlines outlined by the trip organiser. If all payments
are not made by these deadlines your child will be removed from the trip and the full cost of
the trip will remain payable, as the Academy will be unable to get a refund from the provider.
If any unpaid amounts are still owed to the Academy for previous trips then the balance still
owing must be settled in full before a place on another trip will be offered.
I agree to my child taking part in Academy trips and other activities that take place
off Academy premises. I have read, understand and agree to the Academy’s
expectations which include behaviour and payment for trips.
Please tick as appropriate: I give consent I do not give consentHome – Academy Agreement
Aston Academy’s Mission Statement
At Aston we are committed to providing high quality learning and teaching,
enabling everyone to reach their full potential, whatever their age, ability,
gender or ethnicity.
We believe that every person is unique and we work together in an inclusive
environment of mutual respect and consideration, valuing everyone’s
contribution.
Through our partnership with the local and wider community we aim to
support our young people in successfully taking their place in society.
All adults in school have a responsibility to safeguard and promote the
welfare of children.
With your commitment we will make a difference.
Student’s responsibilities
• Attend school regularly and on time
• Wear the correct uniform, P.E kit (unless exempted on religious grounds) and adhere to
all other aspects of the uniform policy.
• Adhere to the rules and behaviour policy of the Academy at all times.
• Behave with respect to every other student and staff member at the Academy and
people in the surrounding community, regardless or their age, ability, gender or ethnicity.
• Tell a teacher / Learning Progress Manager if they are worried or concerned about any
aspect of their schooling.
• Complete all assigned extended learning on time and to the best of their abilities.
• Strive to attain excellence in all its forms through full participation in the academic,
sporting and extra-curricular activities of the Academy.Parent’s/Carer’s responsibilities • Ensure that your child attends school regularly and on time. • Ensure that your child follows all aspects of the uniform policy (unless exempted on religious grounds) and that their P.E kit is brought to the academy when required. • Support the academy by encouraging exemplary behaviour from your child. • Support the academy by ensuring ‘Extended Learning Tasks’ assigned to your child are completed on time and that they have a suitable environment to complete them in. • Encourage your child’s learning through extra-curricular activities and independent learning. • Inform the Academy of any change in your child’s circumstances or you have any concerns regarding any aspect of your child’s learning. • Endeavour to support the Academy, and your child, by participating in any meetings or social activities that the Academy requests you to attend. • Encourage your child to strive for excellence in all aspects of Academy life. Aston Academy’s responsibilities • Provide each student with a safe, inclusive and accessible learning environment. • Provide a balanced curriculum, appropriate to the needs of every student. • Provide regular and rigorous extended learning that sufficiently tests every student. • Expect high standards, exemplary behaviour and mutual respect. • Promote reward and celebrate excellence, achievement and good behaviour. • Record poor behaviour and lack of progress; employing appropriate sanctions, to ensure students achieve their best and maintain the highest standards of behaviour, vital in our learning environment. • Provide extra-curricular activities to develop the broader skills that will assist with the personal, social, physical and cultural development of students. • Respect the rights and needs of all staff, parents and students associated with the academy. • Regularly meet with and/or provide parents/carers with feedback on the progress of their children. • Endeavour to provide all necessary information regarding the policies and activities of the academy and its students. Parental Declaration I, _________________ have read and understood the terms of this agreement and will undertake all reasonable measures to ensure that myself and my son/daughter abide by its contents and contribute to the mission of Aston Academy and to the success of my child. Signature (Student) : Signature (Parent/Carer) :
Lunchtime Arrangements
Students are not allowed off school premises during lunchtime. Unless under
exceptional circumstances. It is expected that your child will have a school meal or
packed lunch. If you feel you are entitled to free school meals please apply via your
local council website.
We use a Cashless Catering System at Aston Academy which is based on biometrics.
The system uses an image of the finger, creates a mathematical algorithm and
then discards the finger image so that only the numbers remain, which cannot be
reinterpreted back into a finger image. THIS CANNOT BE USED BY ANY OTHER
SOURCE FOR IDENTIFICATION PURPOSES.
If you do not want your child’s biometric data to be used for our school meals system
please do not sign below and your child will be provided with a unique code.
Please tick as appropriate: I give consent I do not give consent
Academy Closure
Due to unforeseen circumstances
On very rare occasions it is necessary to send your child home early from school
due to unforseen circumstances. This may be the result of very heavy snowfall,
the breakdown of a boiler or other health and safety conditions. Clearly, we take
decisions of this nature very seriously and the decision to close is only taken in
extreme circumstances. These circumstances can, however, happen and we are
concerned that students are not allowed home without your permission.
You will receive a text message and an announcement will be placed on our website
should the Academy need to close.
If you do not want your child to be sent home without a telephone call to one of the
provided contact details please do not sign below.
I GIVE CONSENT for my child to be sent home early in the case of an emergency
closure without a prior telephone call.
Please tick as appropriate: I give consent I do not give consent
It is important to keep the Academy updated regarding any changes
to the contact details you have provided.Transport
I give consent to my child travelling by any form of public transport, Academy mini-
bus, hired bus or coach, and/or in a motor vehicle driven by the party leader or any
other responsible adult member of the party who is authorised by law and duly
insured to drive.
Please tick as appropriate: I give consent I do not give consent
Personal effects of the student
I acknowledge that my child will be responsible for the safety of his/her own money
and personal effects. I will not hold the Academy responsible for losses unless
caused by the negligence of the Academy.
Please tick as appropriate: I give consent I do not give consent
Photographs & Video Images - Within ACET
Sometimes during a student’s academic career we will use images or video of
students that are members of the ASTON COMMUNITY EDUCATION TRUST (ACET)
family of schools (list of schools available on www.astoncetrust.org). The use of
such images and video could be for displays, presentation events and open events
within our Trust. On other occasions we may use such images/videos in the public
domain, for outside publications or on any of our Academy websites.
I give permission for my child’s image, name or video to be used within all ACET
schools for displays, presentation events, open events and other purposes within
ACET school grounds.
Please tick as appropriate: I give consent I do not give consent
I give permission for my child’s image, name or video to be used in the public domain,
for outside publications such as the Academy prospectus, any of the ACET school
websites and/or Academy social media pages.
Please tick as appropriate: I give consent I do not give consent
I give permission for my child’s image, name or video to be used within ASTON
ACADEMY , for displays, open events, presentation events or other purposes within
the Academy grounds.
Please tick as appropriate: I give consent I do not give consent
I give consent for my child’s image, name or video to be used by external sources
such as journalists and similar digital media uses.
Please tick as appropriate: I give consent I do not give consentPlease ensure you have completed all
tick boxes before signing below
GENERAL DATA PROTECTION
REGULATION (GDPR):
The ACET Privacy Notice is available
online at www.astonacdemy.org.
If you would like a paper copy please
contact the Academy to request one.
Declaration
I agree that the information provided is correct and that I have
completed all tick boxes as required and understand all of these
options.
Print Name (Parent\Carer) :
Signature (Parent\Carer) :
Relationship to child :
Date :You can also read
