Student's Full Name
Burgess Hill - Othello - Special Needs
Crawley - Othello - Special Needs
East Grinstead - Othello - Special Needs
Shoreham - Othello - Special Needs
Emergency Contact Name
Emergency Contact Email
Relationship to child
Emergency Contact Phone
Known Friends At Ariel
Has your son/daughter had any serious illness, operation or accident in the last year? If so, please give details.
Has he/she had any illness during the past year? If so please give details.
Does he/she have any difficulty with a) hearing or b) eyesight
Are you aware of any problems of fainting attacks, tendency to nose bleeds etc, or allergies.
Does your child require any medicines, or special treatment about which the Organisation should be informed? If yes, please give details with instructions/actions that need to be taken in the event of an incident.
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