<p> NOTRE DAME PRIMARY SCHOOL After School Club</p><p>Registration Form – August 2017-June 2018</p><p>Child’s Name D.O.B</p><p>Class Teacher</p><p>After School Requirements Occasional / Ad Hoc</p><p>Regular 3-4.45 pm latest pick up by 5pm (Please tick your preferred days)</p><p>Mon Tues Weds Thurs Fri</p><p>Proposed start date</p><p>Main Contact</p><p>Relationship to Child</p><p>Home/Work No.</p><p>Mobile</p><p>Email</p><p>Emergency Contact</p><p>Relationship to Child</p><p>Home/Work No:</p><p>Mobile:</p><p>Emergency Contact</p><p>Relationship to Child</p><p>Home/Work No:</p><p>Mobile:</p><p>People Authorised to Pick up my child(ren) are</p><p>Name Relationship</p><p>ND ASC Registration Form 2017/18 1 of 3 CONSENT</p><p>Does your child have any medical or dietary requirements including allergies we should know about? If so, please note details in the boxes below…</p><p>Doctor’s Details</p><p>Address</p><p>Telephone</p><p>Medical</p><p>Is your child on any regular medication? Yes No</p><p>If YES please detail</p><p>Does your child require help administering medicine Yes No</p><p>If YES please detail</p><p>Subject Description Yes No</p><p>Short Trips and Are you happy for your child to participate in short trips and activities activities off the premises? Eg. Park, Library, </p><p>Henna Are you happy for your child to receive henna tattoos?</p><p>Are you happy for your child to receive basic first aid by qualified Basic First Aid staff? (eg plasters for wounds)</p><p>Are you happy for staff to sign any written form of consent required Consent by hospital authorities if the delay in getting your signature is considered by them to endanger your child’s health and safety?</p><p>Are you happy for your child to be photographed and for the photos to only be shown within the setting? Photographs Are you happy for photos of your child to be used on the club’s website and printed media (E.g. newsletters, guides)</p><p>Are you happy for photos of your child to be used on the club’s Social Media social media accounts? No personal details will be published. </p><p>Are you happy for your child to be offered high quality, high factor sun screen on sunny days? (Please note children will apply sun Sun Screen screen themselves and we will not force them to wear it if they do not want it.)</p><p>Allergy, Dietary & Are you happy for afty staff to be made aware of your child’s ND ASC Registration Form 2017/18 2 of 3 Medical Info medical and dietary details and included on a reference list.</p><p>I agree to my contact details to be stored electronically and used solely by the After School Club to inform me of updates, activities and issues which affect The After School Club</p><p>P5 – P7 Children only: I give my permission for my son/daughter to leave the after school club unaccompanied. I will contact the After School Club Coordinator with specific instructions and will confirm safe arrival of my child at the designated destination.</p><p>Signed</p><p>Print Name</p><p>Please circle any of the following which you use on a regular basis Facebook Twitter Email Texts</p><p>These forms can also be found on the Notre Dame Primary Parent Council Website http://www.notredame-pri.glasgow.sch.uk and you can email them back to [email protected] Twitter: @NDPAftyGlasgow</p><p>The After School Club is required to involve users in all aspects of the running of the service. The current board is looking to engage parents at a Board level on an ad hoc or advisory level. We welcome parents with specific skills who could ensure that the service is run to a high standard and conforms with Care Inspectorate requirements as well as an ethical business. We also welcome parents with an interest in the quality and type of service we provide. If you would like to get involved at some point we’d be grateful if you could give us the following information. With thanks - The Board</p><p>Profession</p><p>Skills and Knowledge you maybe able to offer</p><p>ND ASC Registration Form 2017/18 3 of 3</p>