St George's School Boarding - OCCASIONAL BOARDING ONLINE BOOKING FORM

Child's Name / Year Group*

First NameSurnameYear Group
Arrival Date/Time*

DayMonthYearHourMinutesAM/PM Option
Departure Date/Time*

DayMonthYearHourMinutesAM/PM Option
Parent Contact 1
E-mail*
Phone Number*

Area CodePhone Number
Parent Contact 2
E-mail
Phone Number

Area CodePhone Number
Guardian (if leaving the UK or further than a 2 hour car journey)
E-mail
Phone Number

Area CodePhone Number
Dietary information
Allergies Information
Medical information
Medicines to administer (please state type, dosage, time)
Please indicate that you give consent for duty staff to administer*

Prescribed medicationParacetamolIbuprofenAnti-histamineStrepsilsRennieIgluAnthisanSavlonArnicareOlbas OilZovirax
Please indicate that you give consent for the school to act in an emergency*

I Give ConsentI do NOT Give Consent
Dorm Preference
Town Visit*
Boarders are permitted to walk into Harpenden after school and before supper. Year 8 must be in groups of 3 and Year 9 must be in groups of 2. Please indicate whether or not you give your child permission to do this.
Any Other Information
Payment can be made by either through Parentpay or by bank transfer and is required in advance.
Should be Empty: