Agreement Booklet
Step 1 of 14 - Basic Details & Contacts 0% Basic Details & ContactsStudent’s legal surname* Gender*MaleFemaleStudent’s preferred surname (if different) Student’s legal first name* Student’s preferred first name (if different) Middle name(s) Home Address* Street Address Address Line 2 City County Postcode Priority Contacts Please give details of all persons who have parental responsibility and anyone else you wish to be contacted in an emergency. Ideally, please provide at least 3 contact names/numbers and place them in the order you wish them to be contacted in an emergency. Priority Contact 1 Title & Full name* Relationship (i.e. Mother)* Home Address* Street Address Address Line 2 City County Postcode Priority Contact 1 Contact Telephone Numbers*Please list in order of preference for contact in an emergencyTelephone NumberHome / Mobile / Work? Priority Contact 2Title & Full name* Relationship (i.e. Mother)* Home Address* Street Address Address Line 2 City County Postcode Priority Contact 2 Contact Telephone Numbers*Please list in order of preference for contact in an emergencyTelephone NumberHome / Mobile / Work? Priority Contact 3Title & Full name Relationship (i.e. Mother) Home Address Street Address Address Line 2 City County Postcode Priority Contact 3 Contact Telephone NumbersPlease list in order of preference for contact in an emergencyTelephone NumberHome / Mobile / Work? Travel & Meal ArrangementsTravel Arrangement*Please tick the most appropriate choice Car Share London Underground Car/Van Public Bus Service Cycle Taxi Walk Train Meal Arrangement*Please tick the most appropriate choice Free School Meal (evidence required) Home Sandwiches Paid School Meal Is your child eligible for free school meals? If you live in Havering or any other borough, free school meal applications should be made to Havering Borough Council; The telephone number for free school meal enquiries is 01708 433929. CLICK HERE to download a booklet explaining the Cashless Catering System, your son/daughter’s biometric scan will be taken during their first few days in school. The system we use is fully GDPR compliant, please see enclosed booklet.I agree for my son/daughter to be registered on the Biometric System*Dietary needs (if any)Doctor’s Surgery Name* Surgery Phone Number*Surgery Address* Street Address Address Line 2 City County Postcode Brief Medical InformationCountry of Birth* Nationality* Religion* Ethnicity* First Language* Home Language* Is English an Additional Language?* Yes No Service PersonnelService Personnel I am designated as Personnel Category 1 or 2 of HM Armed Forces or in the Armed Forces of another Nation and stationed in England Health & MedicalDETAILS OF STUDENT’S EXISTING HEALTH CONDITIONS AND ADMINISTRATION OF MEDICATION It is important that the School is informed of any medical condition(s) suffered by your son/daughter which may affect the child whilst at School, or may require the administration of medication during School time. In some cases it may be necessary to prepare a Health Plan, eg for students with nut allergies and who have been prescribed an epipen. If your child requires a Health Plan or if they have an existing Health Plan, it is essential that you complete the Health Conditions Form below and the School will contact you to discuss Health Care Plans. This is compliant with our GDPR policy which is available on our website and a copy is enclosed with this booklet. Where possible parents should ask GPs to prescribe medication in dose frequencies which enable it to be taken outside School hours. When children need medication regularly, a supply of their medicine may be held in the School Welfare Office for your child to self-administer when necessary. To make such a request, please write to Mrs Liz Evans, describing the medication and dosage. Medication must be supplied in the original container in which it was dispensed, together with the information leaflet. You can ask your GP to split the prescription. It is the student/parents responsibility to check the expiry date of any medication and renew medication when necessary. For certain medical conditions it may be necessary for the School to seek the advice of the Community Paediatrician before agreeing to this. The School reserves the right to refuse to administer any kind of medication.Student’s full name* Health Conditions*Please select one of the following: I confirm that, to my knowledge, the above named child does not have a medical condition which will affect his / her work whilst at School or require the administration of medication during School time I confirm that the above named child has the following medical condition: Medical Condition Details* Medication* The student will require medication for the above medical condition whilst at School The student will not require medication for the above medical condition whilst at School Health Plan*This is only required for students at risk of anaphylactic shock, or who have a serious medication condition, eg diabetes, epilepsy, Crohn’s or Coeliac disease etc. The student requires a Health Plan for their medical condition The student does not require a Health Plan for their medical condition Special Precautionse.g. known allergens, dietary needsIs your son/daughter currently on the SEN register as SEN Support? Yes No If yes please state why. Please indicate if there has been a diagnosis made and if so, when and what was the diagnosis and by who (e.g. GP, Peadiatrician etc)Is your son/daughter currently on the SEN register as EHCP? Yes No If yes please state why. Please indicate if there has been a diagnosis made and if so, when and what was the diagnosis and by who (e.g. GP, Peadiatrician etc)Signature*The name of the signee* First Last Information & Picture Release ConsentStudent’s full name* Parent’s full name* Address* Street Address Address Line 2 City County Postcode Information and Picture PermissionsPhotograph Student - I give permission for photographs/digital images of my child, named above, to be used for promotional purposes of the School, during his/her time here. I understand they may be used in the press.** Yes No I am happy for these photographs/digital images to be used for other promotional purposes including brochures, posters and web-based materials, without payment or further acknowledgement, now and in the future, unless or until permission is revoked by the person giving consent.* Yes No I accept that the copyright of these photographs/digital images remains with the School at all times.* Yes No I am happy for my child to be named in any images used for promotional purposes during his/her time at the School.* Yes No I give permission for details of my child to be passed onto The Youth Support Services, this will enable Careers Interviews to take place.* Yes No Signature*The name of the signee* First Last Mobile Phones & Smart DevicesCode of Practice for Use on the School Site Mobile phones should: Be kept somewhere safe during the school day - preferably locked away. Be switched off at all times during the school day. Be kept safe by the person owning the mobile phone. The school will not take responsibility for the loss of a mobile phone. Students bring them into school at their own risk. Mobile phones may not be used: To take photographs of any other students without their consent. To take photographs of a member of staff. To video other students, events or lessons without the consent of the individuals involved. To send pictures/messages without permission. To send abusive texts to or about another student. This will be deemed as bullying. To disrupt any lesson. To call a parent to invite them into school; the office will contact parents in cases of illness or any other emergency. Sanction If any student is found using a mobile phone inappropriately and, therefore, breaking this Code of Practice, the following sanctions will apply: The mobile phone will be confiscated and kept for a minimum of a ONE WEEK. This is non-negotiable and the length of the confiscation will depend on the circumstances. SIM cards may NOT be removed. Any student resisting confiscation will be isolated and the parent informed immediately. The student will be required to attend a detention after school. For repeated use of a mobile phone inappropriately, parents will be informed and the phone will be kept for a much longer period of time. We thank you for your anticipated cooperation in this matter and assure you that we believe such measures to be in the best interests of all. Would you please return the acknowledgement slip below to confirm that you have received and understood this communication?Student’s full name* I have read the letter about the use of MOBILE PHONES/SMART DEVICES and understand the consequences of my son/daughter being found in possession of a mobile phone in school.*Parent or Guardian SignatureParent or Guardian Name* First Last ParentmailDear Parent, The School uses a service called ParentMail which enables us to send letters and messages direct to parents by email and text message. ParentMail has proven to be the most efficient way of ensuring that parents actually receive communications from the School. In line with the School’s Sustainability Policy, we are seeking to ensure as much as possible that all communication is electronic. Accordingly, please ensure that the School has an up to date email address and mobile telephone number by completing the Form below. If you do not have access to an email account, please obtain one if this is at all possible. If you require support in this please contact the Admissions Secretary by letter. Please be assured that the Parentmail system is fully compliant with GDPR and it guarantees that all information supplied will be kept completely private. I am able to receive information and give permission for my email address(es) and mobile number(s) to be registered with ParentMail®. Student’s full name* Parentmail Contact Details*Parent nameParent email(s)Parent mobile(s) Art DepartmentYour son/daughter is embarking on an Art and Design course over the next three years at the School and all students will require a sketchbook to conform with National Curriculum recommendations. You will need to purchase an A3 Hardback sketchbook embossed with the name of the School in gold. Sketchbooks will be delivered to us at the beginning of the autumn term and distributed to students. Hardback sketchbooks as described above are available at the price of £15.00. You are, of course, under no obligation to buy through the School and you may wish to purchase elsewhere. However, it represents excellent value for money, and I would recommend that you give this serious consideration. Please visit the School Shop on the School Website (School Shop) where you can select the option to purchase the Art Book. Please ensure you put your child’s name clearly in the space provided. Mr P Withyman, Head of ArtA3 Hardback sketchbook* I have already purchased an A3 Hardback sketchbook from the school I intend on purchasing an A3 Hardback sketchbook from the school I will purchase an A3 Hardback sketchbook elsewhere Food Preparation and Nutrition Your son/daughter will be studying Food Preparation and Nutrition in Years 7-9. To avoid the collection of small amounts of money, we would like to collect one sum of £25. The money will cover incidental items such as flour for dredging, oil for greasing and seasonings as well as food materials for group task lessons.Under the terms of the Education Reform Act 1988 the provision of ingredients and payment for completed articles/dishes can only be made on a voluntary basis. The purpose of communicating at this stage is to ask if you are willing to grant your continued support and give your permission to allow your son/daughter to comply with requests to supply ingredients for practical lessons. Every effort will be made to keep costs to a minimum and a recipe booklet will be provided. Please complete the slip.To pay the £25 contribution please visit the School Shop on the School Website (School Shop) where you can select the option Food Technology. Please ensure you put your child’s name clearly in the space provided.May I also take this opportunity to ask you to help your child prepare and weigh out their ingredients accurately (especially in Year 7), prior to their practical lessons and ensure that they have the right equipment including a container for transportation. Failure to do this may result in your child being unable to take part in the lesson. As aprons are frequently misplaced, and as stated in Uniform Requirements in the New Students’ Information Book, could you please ensure your child’s name is embroidered, in red, on the bib.Please do not hesitate to contact me should you have any queries concerning this information.Mrs J RuthHead of Food Preparation and NutritionMy son/daughter may be requested to supply ingredients for Food Preparation and Nutrition during Years 7-9* I agree I do not agree Student’s full name* Parent or Guardian Signature*Parent or Guardian Name* First Last Rules For Internet UseEach student at this school is offered individual access to the resources of the Internet and to associated e-mail facilities. Before being allowed to use the individual access facility, students must obtain parental permission, and both the student and the parent must sign and return the attached slip, as evidence of your approval and acceptance of the school’s “Rules for Internet Use”. The rules for reference are given in the Student Information Book and these rules are available for students to view each time they log on. As a School, we are happy that the Internet provides a wealth of educational opportunities and that, if used responsibly, will prove to be an invaluable tool. We are confident that our students, with the support of their parents, will acknowledge this responsibility and will make full use of the resource. We would be grateful if you could read the enclosed “Rules for Internet Use” in the New Students Information Book and then complete the slip below. Mrs J Harris Assistant Head i/c IT SupportStudent’s full name* I have read and understood the school’s “Rules for the Internet” document in the New Student Information Book and agree to comply with these rules when using the Internet and associated e-mail facility. I understand that a failure to abide by the rules will result in an immediate withdrawal of the facility and may lead to possible further sanctions or exclusion from school.*Student SignatureAs the parent of the student signing above, I grant permission for my child to use electronic mail and the Internet. I understand that students will be held accountable for their own actions, and that failure to comply with the rules may result in disciplinary action.*Parent / Guardian Signature Print TrackerI have read the print tracker details in the New Student Information Book and understood the information given. Student’s full name* Address* Street Address Address Line 2 City County Postcode Parent or Guardian Signature*Parent or Guardian Name* First Last Application For Music Lessons Please note that by completing this form you are committing to tuition for the duration of the Autumn term. Written notice must be given by the end of the first half term if you wish to terminate at the end of the termStudent’s full name Address Street Address Address Line 2 City County Postcode Email Home Telephone NumberMobile Telephone NumberName of parent to whom invoice should be sent Individual lessons are offered on a fee paying basis for the following instruments: Violin, Trumpet/Cornet, Keyboard, Cello, Trombone, Guitar (acoustic), Flute, E Horn, Guitar (electric), Oboe, French Horn, Drum Kit, Clarinet, Tuba, Theory, Saxophone, Piano, Voice Ten x 30 minute / twelve x 30 minute (specific to the teacher) lessons per term currently charged at £165 / £198 per term. On receipt of your application we will appoint a specialist teacher for your choice of instrument and you will receive an invoice. All payment details will be on your invoice which will be emailed to you at the start of each term. Please ensure that your child has an instrument (or has arranged to hire one) before lessons commence. Please do not make any payment until you have received your invoiceFor which instrument does your son/daughter require lessons?ViolinTrumpet/CornetKeyboardCelloTromboneGuitar (acoustic)FluteE HornGuitar (electric)OboeFrench HornDrum KitClarinetTubaTheorySaxophonePianoVoiceIs he/she a beginner? Yes No How long has he/she been learning? Approximately what grade/standard has he/she reached? Does he/she possess an instrument? Yes No Would you be interested in hiring an instrument if available? Yes No Please ensure that your child has an instrument before lessons commence. The Music Administrator, Mrs McArdle, can be contacted at jmd@cooperscoborn.co.uk Physical Education and SportPhysical Education and Sport is seen as an important entitlement to all of our students. During the course of the year your son/daughter may have the honour of being asked to represent the School. In most cases fixtures will be after school but occasionally due to cup games and the latter rounds of National Competitions it may be necessary to leave during school hours. Students will be given a minimum of 24 hours notice of fixtures and we welcome support of parents to both home and away fixtures. We would ask parents to return the reply slip below giving your permission. If students are missing lessons, it is important that they seek permission from staff concerned and make arrangements to make up any work that is missed. If a student’s attainment/behaviour drops this may jeopardise their participation in fixtures going forward. AN IMPORTANT SAFETY MESSAGE FROM THE SPORTS DEPARTMENT Gum Shields Now that the sports season is about to commence, it is time to start thinking about gum shields. Not a subject to get hugely excited about, but perhaps one that shouldn’t be taken lightly either. We have a very clear policy that the wearing of custom fitting mouth guards is strongly recommended whilst playing contact sports, particularly rugby and hockey. The qualities of the mouth guards, which are individually named, are excellent, and in addition, the model of your child’s mouth is kept by the O-Pro laboratory, so that should one be needed, a replacement can be easily supplied at a lower cost. The mouth guard price also includes very comprehensive dental insurance in the event of injury. It is now a very strong recommendation by the Rugby Football Union, the England Hockey Association and the British Dental Association that all children should be fitted with these. Please look at the enclosed leaflet, and reply directly to O-Pro (and not to the School) if you wish to have an O-Pro made you will need to book this via the O-Pro website. Alternatively, if your child already has a gum shield, would like to buy one from a Sports shop or your own dentist this is also acceptable. We can also recommend Pure Orthodontics, Chelmsford, https://www.pureorthodontics.co.uk It is imperative that the gum shield fits properly, please take a moment to check that it fits – a child’s growth does limit the lifespan of the gum shield. Helen Davies Head of Physical Education Student's full name* PE Fixtures Consent*I give permission for the student named above to leave school to attend sports fixtures. I understand that this may occur during the day or after school, having been previously notified by my child. While School staff in charge of the party will take all reasonable care of the Students, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child, which might occur as a result of the fixture. I also understand that whilst attending school fixtures pictures may be taken for promotional purposes and these may be published with student’s names. Yes No Parent or Guardian Signature*Parent or Guardian Name* First Last Year 7-11 Behaviour Policy Contract The addendum to the School Behaviour Policy identifies the main expectations of students during their time with us. It highlights, but not exclusively, some of the key points from the School Behaviour Policy and other associated documents such as the Coopers’ Coborn Charter, ICT User Agreement, Uniform Policy and Mobile Phone Policy. The school has an outstanding reputation for both academic excellence and high achievement in sport, music and drama. The ethos of the school is reflected in the high quality relationships that exist between students and staff, which embody the school’s motto “Love as Brethren”. The points below are not exclusive and are a summary of the school’s behaviour policy. The full policy is available on the school’s website. As a student at The Coopers’ Company and Coborn School, I will: Adhere to the Coopers’ Coborn Charter to ensure the school can be a positive and safe environment, where effective learning takes place. Bring resources to lessons as necessary. Provide a positive role model for younger students. Abide by the uniform policy; in particular I understand the hair/appearance code. All uniform must be worn correctly. Shirts must be tucked in, ties knotted correctly and skirts worn at knee Trousers and skirts should be ‘regular fit’ style and not overly tight. Shoes should be formal, leather-style and plain black. Follow the Mobile Phone Policy. My mobile phone will be switched off and out of sight. If seen at any point between 8.35am and 3.25pm, without permission, it will be confiscated and handed to the school office with the current policy applied. Follow the ICT User Agreement at the school. Not act in such a way so that I might bring the reputation of the school into disrepute. Strive to achieve the highest academic standards of which I am capable. Respect the school site. Meet homework and coursework deadlines. Return all school issued equipment at the end of the course. I understand that the school defines bullying as any behaviour or deliberate actions that hurt or make another person unhappy. This includes all acts of physical, verbal, psychological and emotional aggression. I will report incidents of bullying to a member of staff. Misbehaviour is considered to be a persistent breach of any of the following points. In particular, please note that poor attendance, lateness, or submitting work of poor effort are considered disciplinary breaches of the School Behaviour Policy. Signed by the school: Ms S Hay, Head Teacher I will comply with the School Behaviour Policy Contract. I understand that non-compliance with the agreement will result in sanctions being put in place.Student's Signature*Student's Name* CommentsThis field is for validation purposes and should be left unchanged.
