St Bernard's Preparatory School

Student details

Child's first name* Child's surname* Date of birth* Nationality* Religion/Faith* Please describe your child's gender* Special home circumstances, if any:

Medical conditions

Does your child have any medical conditions we should be aware of* If yes please provide further details

Allergies

Does your child have any allergies we should be aware of* If yes please provide further details Previous school or nursery* Previous school or nursery's address* Previous school or nursery's telephone number* Proposed date of entry* Do you have any siblings attending the school?

Do you wish to make use of the Government's provision of Funded Learning giving you up to 15 universal hours a week (term time only) of free tuition for 2-3 year olds? Please note we only take children from aged 2.5 years.YesNo

Do you wish to make use of the Government's provision of Funded Learning giving you up to 15 universal hours a week (term time only) of free tuition for 3 and 4 year olds?YesNo

Do you wish to make use of the Government's provision of Funded Learning giving you up to 30 extended hours of a week (term time only) of free tuition for 3 and 4 year olds?*YesNo

Click here to find out more about funding

Do you give consent to use any photograph that includes your child for promotional activities? Some images may be selected to use on the school website, on social media and in the press.*YesNo

How did you hear about us?*

Parents' details

Mother/Guardian* Address* Occupation* Place of Work* Contact number(s)* Email* Father/Guardian* Address Occupation Place of Work Contact number(s) Email Please upload pupil photo and baptismal certificate, if applicable here. No file chosen Please upload a birth certificate No file chosen

Please submit your £100 registration fee with this form to Barclays Bank, Account Name: St Bernards Prep School, Account No. 30588172, Sort Code 20-72-17*I confirm payment has been made via bank transfer

Emergency contact

Name* Contact number* Relationship* Office use only. Birth certificate seen? Date of registration and deposit

Declaration

• I/We have carefully read the school prospectus and all attached general rules and conditions relevant to my/our son/daughter’s admission. I/We agree to support the general rules and conditions as described. Furthermore I/we agree to be bound by and adhere to rules regarding advanced fee paying and that in the absence of one full term’s notice of removal in writing, a term’s fees will be payable.

• I/We request that my/our child be registered as a candidate for admission to St Bernard’s School and will make a payment of 100.00 GBP registration fee electronically. This is a non-refundable administration cost payable before my child attends a 'getting to know' / mini-assessment session at St Bernard's Preparatory School. Once a place at St Bernard’s Preparatory School has been confirmed, you will be required to pay a deposit of 500.00 GBP. This will be refunded to you following your child’s final term at the school, subject to the school being given the required one term’s notice as per the terms and conditions of the contract.

Payment for both the registration fee and the deposit can be made via Barclays Bank, Account Name: St Bernards Prep School, Account No. 30588172, Sort Code 20-72-17.

I/we understand that this deposit is also non-refundable if I/we do not subsequently take up the offer of a place.

• In the event that our child is offered a place at the School, such an offer will be subject to the School’s terms and conditions for the provision of educational services, which will bind us in the event that I/we accept the place.

• I/we confirm that any and all information that I/we have provided to St Bernard’s Preparatory School in respect of my/our son/daughter is true, accurate and complete in all material respects and I/we accept responsibility for all fees incurred.

• I/we agree to support the school in maintaining its ethos as set out in the prospectus and in maintaining good standards of behaviour and conduct. I/we have been advised that a complaints procedure is available at the school office, as are all the other school policies.

Data Protection. We understand also that the school (through the Headteacher, as the person responsible) may obtain, process and hold personal information about our child including information such as medical details, and we consent to this for the purposes of assessment and, if a place is later offered, in order to safeguard and promote the welfare of the child.

By checking the I agree box and choosing submit you agree that failure to give correct information will constitute a material breach of any agreement(s) entered into between the school and you in relation to the education of the applicant pupil. This will entitle the school to terminate all and any such agreement(s) without any obligation to return any deposit or fees paid.

Please confirm*I agree to the above and confirm that I have paid the 100.00 GBP registration fee to Barclays Bank, Account Name: St Bernards Prep School, Account No. 30588172, Sort Code 20-72-17. I understand that a 500.00 GBP deposit will be due to secure my child's place, refundable when my child leaves St Bernard's Prep School.