LAL Young Learner’s Student Welfare Form

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Step 1 of 9 - Preamble

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Dear Parent

Thank you for choosing an LAL school. We put your child’s safety at the top of our list of priorities and for us to do this, we would like you to spend a few minutes to complete this form so that we have all the vital information we need. When you have submitted it, we will receive it automatically so there is no need to print it or for your student to bring it. If you need to re-submit, please do so and we will ignore the first version.

Please make sure that any text you write, including your child’s name, uses the Roman alphabet.
This data is only accessible, via a secure website, to staff who are authorised by LAL to see it. LAL will hold this data for 30 days after departure date. At this point, LAL will remove the data from the database and, for insurance purposes, hold it in archive for a further 90 days. Please feel free to read our Privacy Policy on our website.

We appreciate you taking the time to do this and we hope that your child will have a productive, fun and, most importantly, safe time with LAL.

School and Booking Information
OLD: Is your child attending more than one school?
- Yes
- No
Is your child attending more than one school?
- Yes
- No
School*
If attending more than one school, please input the first school.
2nd School*
If attending more than one school, please input the second school.
Arrival Date*
Date Format: DD slash MM slash YYYY
Departure Date*
Date Format: DD slash MM slash YYYY
Booking through an agency?*
- Yes
- No
Agency Name?*
Group Leader Name (if known)

Student Details
Name*
First Name Family Name/Surname
Student Photo
Accepted file types: jpg, gif, png.
Head and shoulder photo (passport style) Maximum file size 5MB
Sex*
- Male
- Female
Nationality*
Other Nationality
Please specify
Date of Birth*
Date Format: DD slash MM slash YYYY

Student Contact Details
Street Address*
Address Line 2
City*
State / Province / Region
ZIP / Postal Code
Country*
Student’s E-mail Address*
Enter Email Confirm Email
Student’s Mobile Number*
Please include country code. If no mobile phone, type "None"
Student’s Mobile Number while in the UK
Please fill this in only if you have a different number while in the UK. Please include country code.

Parent or Guardian Information
Parent’s E-mail Address*
If no e-mail, type [email protected]
Enter Email Confirm Email
Parent/Guardian’s Contact Number*
Please include country code.
Alternative Parent/Guardian’s Contact Number
Please include country code.
Does Parent/Guardian speak English?*
- Yes
- No
Emergency Contact Number*
English speaker, if parents do not speak English. Please include country code.
Parent/Guardian’s Location during course*
Please specify*
If Other or Holiday is chosen

Student Health and Dietary Information
Special Dietary Information*
- Vegetarian
- Coeliac
- Vegan
- Lactose intolerant
- Nut allergy
- Other
- None
Other Special Dietary Information*
Any Allergies?*
- Yes
- No
Note Any Allergies*
Any Medical Problems?*
By choosing No, you are confirming that your son or daughter has no medical condition which could affect his or her stay with LAL. Any expenses incurred by LAL as a result of unstated medical conditions will be charged to you.
- Yes
- No
Note Any Medical Problems*
Please tell us what the problem is/was, the period of time of the problem and what medication the student is taking. (e.g. Diabetes, from the age of 2 until now, insulin by needle)

Medical Consent
In the event of a cold, minor injury or illness can we give/administer to your child:
Paracetemol*
- Yes
- No
Aspirin*
- Yes
- No
Ibuprofen*
- Yes
- No
Antiseptic cream*
- Yes
- No
Sun cream*
- Yes
- No
Can LAL authorise any urgent medical treatment in your absence?*
- Yes
- No

Parental Consent
Students may be unsupervised for small periods of time e.g. free time on excursions, on campus between activities and meals, walking to and from homestays.

Students will be transported on excursions using private coaches but in some instances, LAL uses public transport. For the USA, most excursions use public transport with some using private coaches.
Students staying in homestay accommodation may be asked to take public transport after activities – please check the timetable for more information.
Students must adhere to the LAL Student Code of Conduct, available on our website.
Can your child swim?*
- Yes
- No
Will your child be 16 or over during their stay at LAL?*
- Yes
- No
Is your child allowed to leave the LAL Berkhamsted campus?*
(students are only allowed to leave the campus in groups of 3 or more if 16 or over)
- Yes
- No
Is your child allowed to leave the LAL Brighton campus?*
(students are only allowed to leave the campus in groups of 3 or more if 16 or over)
- Yes
- No
Is your child allowed to leave the LAL London Twickenham's campus?*
(students are only allowed to leave the campus in groups of 3 or more if 16 or over)
- Yes
- No
Taking photos on the course*
From time to time, LAL employees or representatives may take photos or video of students to be used for LAL’s publicity purposes only. If you do not wish your child to have their image used for publicity purposes, please indicate here. It is important that you have uploaded a photo of your student on page 2 of the form. LAL abides by all Data Protection legislation and we guarantee the security of any images of minors.
- Yes, LAL can use the images
- No, LAL cannot use the images
Any other information which you think LAL should know:

Confirmation
Insurance*
LAL automatically includes health insurance for students travelling to the USA and South Africa, and travel and health insurance for students travelling to the UK. If you have taken out further insurance cover, please indicate here.
- Yes
- No
For further information about the LAL insurance cover, please go here
Confirmation
These are the details you have submitted. Please check them and sign below to confirm that they are correct
{all_fields}
Date
Date Format: DD slash MM slash YYYY
Parent/Guardian Name*
Consent
I agree that all information given is accurate, and that I am the parent or official guardian of the student mentioned.
LAL complies with current Data Protection legislation and this data will be removed from our files according to our Privacy Policy, available on our website.
Email
This field is for validation purposes and should be left unchanged.

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Step 1 of 9 - Preamble

School and Booking Information

Student Details

Student Contact Details

Parent or Guardian Information

Student Health and Dietary Information

Medical Consent

Parental Consent

Confirmation

Confirmation