Broadfield Academy

Name of Child attending the class *

First

Last

Year *

Year 3
Year 4
Year 5
Year 6

Please select the year group your child is currently in.

1st Emergency contact name *

First

Last

1st Emergency contact phone number *

2nd Emergency contact name *

First

Last

2nd Emergency contact phone number *

Parent/guardian email address: *

We would like to send letters to parent/guardians directly via email rather than printing and handing to students. Partly to reduce paper usage, partly to guarantee letters are seen by parents.

Any medical details we may need to know *

Classes my child will be attending:

Drama- Thursdays 3:15-5pm

I give my permission for my child to attend the Expressions Academy extra-curricular classes *

Yes

Expressions Academy is required to seek permission of parents and carers before recording or photographing any images of your children. Please tick one of the following: *

I DO give permission for Expressions Academy to record and use footage of my child for website, social media, advertising and end of project video purposes.
I DO NOT give permission for my child to be in any photography or footage.

Do you consent to your data being used for the following: *

Used for communication about the relevant class or event, e.g cancellation, reminders etc.
Added to our newsletter subscription list to send out termly emails informing you of what is coming up.
Added to our database for auditing purposes and to avoid filling out another registration form in the next two years for repeated events or classes.
None of the above.

Date of form completed and submitted:

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