Parental Information Form Parental Information Form Please ensure you complete all fields marked with a red asterisk and press the 'Send Form' button at the end when you have completed it. * Family surname: * First name child 1: First name child 2: First name child 3: First name child 4: Name of other contact in case of emergency: Other contact's phone number: Second alternative contact name: Second alternative contact number * Name of doctor: * Doctor's address: * Doctor's telephone number: * In order for the Cheder to provide a happy and safe place for your child/children, please let us know details of any medical conditions: Asthma Allergies (Please specify below) ADHD Autism (Please specify below) Food intolerances (Please specify below) Other (Please specify below) N/A * IN THE EVENT OF A MEDICAL EMERGENCY, I AUTHORISE THE RELIGION SCHOOL STAFF TO OBTAIN EMERGENCY MEDICAL TREATMENT FOR MY CHILD Yes I give my consent No I do not give my consent By selecting the 'yes' button and completing your name below The Wimbledon Synagogue Religion School understands that you have given your consent to this option. * Parent's name: * From time to time there are off site trips for which individual notices will be given. It will be helpful if you could give your general consent for your child to be included in these trips here: Yes I give my consent No I do not give my consent * We are occasionally asked to use the parent email list to send information about Synagogue matters other than the Heder and also about other Jewish organisations and events. Please indicate if you agree to this: Yes I give my consent No I do not give my consent * From time to time your child may be involved in projects that involve photography or video being taken which will feature your child. Please indicate if you agree to this: Yes I give my consent No I do not give my consent * We would like to distribute a class list to parents in your child’s class with your contact details so you can be informed of class events, childrens’ birthday parties etc. Please indicate if you agree to this: Yes I give my consent No I do not give my consent * One more step