Consent Form for Extra Sessions You must complete a separate form for each child. Please give full information, especially for medical questions. For details of data protection, please see our policyParent/Guardian InformationName of parent/guardian* First Last Email address for parent/guardian 1* This will be used for regular communication from Griffin Teaching so please make sure that is current and checked regularly.Daytime phone number*Evening phone numberMobile phone numberName of additional parent/guardian (optional) Child InformationName of child* First Last Child known as... If your child has a shortened version or alternative preferred first please let us know - this will be used for the registerChild's date of birth* Day Month Year First line and postcode of child's home address* Does your child have any specific educational needs?* yes no Please give full details of any special educational needs*Does your child have any medical conditions we should be aware of?* yes no Please give full details of any medical conditions we should be aware of*Medical treatment consent*If it becomes necessary for my child to receive medical treatment and I cannot be contacted by telephone or other means to authorise this, I hereby give my general consent for the tutor in charge of the class to authorise any medical treatment necessary and to sign any document required by the hospital authorities. yes no Contact information for the GP your child is registered withThis is used for only for contact in a medical emergency situation.Phone number of the GP*Name of the GP* First line and postcode of GP surgery address* Consent* I give permission for all information provided to be kept on file for the period of the extra sessionsWould you like to fill out an Extra Session Consent Form for another child now?* yes no 2130
