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Parent/guardian consent form

Royal Holloway, University of London Parental/Guardian/Carer Consent Form for Year 12 Summer University

For your child to be able to attend the Year 10/11 Spring or Year 12 Summer University 2021 programmes, we will need all parts of this form completed and submitted by the deadline: 18th April 2021.

Who is the consent form for?

To make sure we can match your consent form to your child, please could you confirm their name and School/College below.

Section 1: Next of Kin

Parent/guardian/carer name and contact details.

Name

Second next of kin contact if parent/guardian/carer is unavailable:

Name
Section 2: Medical information & special requirements

Family doctor's name, address and telephone number.

Address

Note: Staff members of the Summer University are unable to administer any medication to your child. Students with longer-term medical needs should have a Health Care Plan. In this case, please email the plan with the name and school of your child to: schools@royalholloway.ac.uk

If your child does not have any special requirements, please tick N/A.

Section 3: Consent for photography and filming

During the event photographs and video filming may be taken of your child. These materials may be used in the future to promote our Summer University.

Consent for applicant to attend the Year 12 Summer University

Failure to complete this form correctly may hinder your child's application to attend the Summer University. Please review the form before submitting it.