Student / Child Registration Form

Annual enrolment / registration form

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How to use this template

• Complete one form per child for each enrolment year, and replace it at the start of every new year so information stays current.
• Sections must be completed by a parent or guardian who holds legal parental responsibility for the child — they are the person authorised to give the consents in Section 6.
• Answer every Yes/No checkbox; leave no consent item blank, as a blank box cannot be treated as agreement.
• Mark “N/A” where an optional field does not apply rather than leaving it empty, so the organisation knows the field was seen.
• Provide at least one emergency contact who is not the primary guardian; a second contact is strongly recommended so someone is always reachable.
• Tell the organisation promptly whenever any detail changes during the year — especially contacts, medical information, or who may collect the child.

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Section 1: Organisation details

Organisation name: [ORGANISATION NAME] Site / location: [SITE OR LOCATION] Class / team / group: [CLASS, TEAM OR GROUP] Year / season: [ENROLMENT YEAR OR SEASON] Date of enrolment: [ENROLMENT DATE]

Filled in by the organisation or by staff at intake — identifies which group the child is joining and for which period.

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Section 2: Child details

Full legal name: [CHILD FULL LEGAL NAME] Preferred name (if different): [CHILD PREFERRED NAME] Date of birth: [CHILD DATE OF BIRTH] Sex / gender: [CHILD SEX OR GENDER] Home address: [CHILD HOME ADDRESS] Language(s) spoken at home: [LANGUAGES SPOKEN AT HOME] Child photo for identification (optional): [ATTACH OR PASTE CHILD PHOTO]

Enter the child’s identity exactly as it appears on official documents. The identification photo is optional and used only to help staff recognise the child.

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Section 3: Parent / Guardian details

Guardian 1

Full name: [GUARDIAN 1 FULL NAME] Relationship to child: [GUARDIAN 1 RELATIONSHIP] Holds legal parental responsibility: ☐ Yes ☐ No Address: [GUARDIAN 1 ADDRESS] Mobile phone: [GUARDIAN 1 MOBILE] Alternate phone: [GUARDIAN 1 ALTERNATE PHONE] Email: [GUARDIAN 1 EMAIL]

Guardian 2 (if applicable)

Full name: [GUARDIAN 2 FULL NAME] Relationship to child: [GUARDIAN 2 RELATIONSHIP] Holds legal parental responsibility: ☐ Yes ☐ No Address (if different): [GUARDIAN 2 ADDRESS] Mobile phone: [GUARDIAN 2 MOBILE] Alternate phone: [GUARDIAN 2 ALTERNATE PHONE] Email: [GUARDIAN 2 EMAIL]

Primary contact for day-to-day matters: ☐ Guardian 1 ☐ Guardian 2 Order in which to contact guardians: [CONTACT ORDER] Interpreter or language support needed (optional): [LANGUAGE SUPPORT NEEDS] Custody, court-order or parental-responsibility notes (optional): [CUSTODY OR PARENTAL RESPONSIBILITY NOTES]

List each guardian and clearly indicate who holds legal parental responsibility, as only such a person can give the consents below. Note any custody arrangement the organisation should be aware of.

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Section 4: Emergency contacts

Provide at least one emergency contact who is not the primary guardian. A second contact is recommended so someone can always be reached.

Emergency contact 1

Full name: [EMERGENCY CONTACT 1 NAME] Relationship to child: [EMERGENCY CONTACT 1 RELATIONSHIP] Phone: [EMERGENCY CONTACT 1 PHONE] Alternate phone: [EMERGENCY CONTACT 1 ALTERNATE PHONE] Address (optional): [EMERGENCY CONTACT 1 ADDRESS]

Emergency contact 2 (recommended)

Full name: [EMERGENCY CONTACT 2 NAME] Relationship to child: [EMERGENCY CONTACT 2 RELATIONSHIP] Phone: [EMERGENCY CONTACT 2 PHONE] Alternate phone: [EMERGENCY CONTACT 2 ALTERNATE PHONE] Address (optional): [EMERGENCY CONTACT 2 ADDRESS]

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Section 5: Medical & health information

This section contains health information, which is sensitive. It is collected to keep the child safe and care for them appropriately. Write “None” where a field does not apply.

Allergies — list each allergy, its triggers and severity: [ALLERGIES, TRIGGERS AND SEVERITY] Medical conditions or disabilities: [MEDICAL CONDITIONS OR DISABILITIES] Regular medications and administration instructions: [REGULAR MEDICATIONS AND INSTRUCTIONS] Dietary requirements or restrictions: [DIETARY REQUIREMENTS OR RESTRICTIONS] Doctor / GP name: [DOCTOR OR GP NAME] Doctor / GP phone: [DOCTOR OR GP PHONE] Swimming ability / relevant activity competencies (optional): [SWIMMING OR ACTIVITY COMPETENCIES] Religious or cultural observances affecting care (optional): [RELIGIOUS OR CULTURAL OBSERVANCES] Preferred hospital / health-insurance details (optional, where applicable): [PREFERRED HOSPITAL OR INSURANCE DETAILS]

The optional fields above may not apply in every country or context — leave them blank or mark “N/A” if not relevant.

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Section 6: Authorisations & consents

Complete every item below. These authorisations must be given by a person with legal parental responsibility (see Section 3).

6.1 Emergency medical treatment

In an emergency, the organisation will attempt to contact you using the details above before any decision is made. If you cannot be reached in time, do you authorise staff to seek and consent to urgent medical treatment advised by a qualified professional?

☐ Yes ☐ No

This is a practical authorisation to act when you cannot be reached — it does not replace your right to be consulted.

6.2 Administration of medication

Do you consent to staff administering the regular medication listed in Section 5, following your written instructions? ☐ Yes ☐ No ☐ Not applicable

Do you consent to staff administering basic over-the-counter medication (e.g. for pain or fever) where appropriate? ☐ Yes ☐ No

Over-the-counter consent is optional; the organisation may contact you before administering anything.

6.3 Authorised pick-up persons

People — other than the guardians in Section 3 — authorised to collect the child:

1. Name: [AUTHORISED PICK-UP PERSON 1 NAME] — Relationship: [PICK-UP PERSON 1 RELATIONSHIP] — Phone: [PICK-UP PERSON 1 PHONE]
2. Name: [AUTHORISED PICK-UP PERSON 2 NAME] — Relationship: [PICK-UP PERSON 2 RELATIONSHIP] — Phone: [PICK-UP PERSON 2 PHONE]
3. Name: [AUTHORISED PICK-UP PERSON 3 NAME] — Relationship: [PICK-UP PERSON 3 RELATIONSHIP] — Phone: [PICK-UP PERSON 3 PHONE]

Persons NOT permitted to collect the child (optional): [PERSONS NOT PERMITTED TO COLLECT]

List only adults you authorise. Staff may ask any collector for proof of identity.

6.4 Photo / media consent

This consent is granular and may be withdrawn at any time by contacting the organisation.

• Use the child’s image in internal records and displays: ☐ Yes ☐ No
• Use the child’s image in printed materials (newsletters, brochures): ☐ Yes ☐ No
• Use the child’s image on the organisation’s website: ☐ Yes ☐ No
• Use the child’s image on the organisation’s social media: ☐ Yes ☐ No

A separate answer is needed for each line — leaving a box blank is treated as “No”.

6.5 Local off-site outings (standing consent)

Do you give standing consent for the child to take part in local, supervised off-site activities within walking distance? (You will be informed separately about any travel further afield.)

☐ Yes ☐ No

6.6 Routine communications

Do you consent to receive routine, non-emergency communications from the organisation by:

• Email: ☐ Yes ☐ No
• SMS / text message: ☐ Yes ☐ No

This covers updates and reminders only. Emergency contact will always be made regardless of this choice.

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Section 7: Parent / Guardian declaration & signature

I confirm that I hold legal parental responsibility for the child named in Section 2, that the information provided in this form is accurate and complete to the best of my knowledge, and that I have completed the consent items in Section 6. I agree to notify the organisation promptly of any change to the contact, medical, or authorisation details recorded here. I confirm I have read the data protection notice in Section 8.

Printed name: [GUARDIAN PRINTED NAME] Relationship to child: [GUARDIAN RELATIONSHIP] Signature: [GUARDIAN SIGNATURE] Date: [SIGNATURE DATE]

Second guardian (optional): Printed name: [SECOND GUARDIAN PRINTED NAME] Signature: [SECOND GUARDIAN SIGNATURE] Date: [SECOND GUARDIAN SIGNATURE DATE]

Must be signed by a person with legal parental responsibility. A second guardian signature is optional but helpful where parental responsibility is shared.

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Section 8: Data protection / privacy notice

The organisation completes the placeholders below before issuing the form.

Who controls your data: [ORGANISATION NAME], [ORGANISATION ADDRESS], contactable at [DATA CONTACT EMAIL].

Why we collect this information (purpose): to enrol and care for the child, to contact you, to respond to emergencies, and to deliver our activities safely.

Lawful basis: we rely on your consent for optional items such as photo/media use and routine communications. Health, allergy and disability details are sensitive (special-category) information, collected with your explicit consent and, in an emergency, to protect the child’s vital interests.

Who we share it with: information is shared only with staff who need it, and with emergency or medical services where necessary to protect the child. [ANY OTHER RECIPIENTS]

How long we keep it: the organisation retains this form for [RETENTION PERIOD SET BY ORGANISATION], after which it is securely deleted or destroyed.

How we protect it: the form is stored securely with access limited to authorised staff. [ADDITIONAL SECURITY MEASURES]

Your rights: you may ask to access, correct, or delete the information, object to certain processing, and withdraw any consent at any time without affecting processing already carried out. To do so, contact [DATA CONTACT EMAIL]. You may also raise a concern with the relevant data protection authority.

Acknowledgement: I have read and understood this data protection notice. ☐ Yes

[GUARDIAN INITIALS] — Date: [ACKNOWLEDGEMENT DATE]

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Section 9: For organisation use only

Completed by staff — not by the parent or guardian.

Form received by: [STAFF NAME] Date received: [DATE RECEIVED] Identity / parental responsibility documents checked: ☐ Yes ☐ No Medical information reviewed and circulated to relevant staff: ☐ Yes ☐ No Consents recorded in organisation system: ☐ Yes ☐ No Record reference / file number: [RECORD REFERENCE] Review / renewal due: [NEXT REVIEW DATE] Notes: [STAFF NOTES]