Lightcliffe Academy Admission Form

Student Admission Form

Welcome to Lightcliffe Academy

Please read the Student Information carefully before completing the Admission Form

Further information about how we use the data you provide, including comprehensive Privacy Notices for both Parents/Carers and students, can be found on the Academy website.
Student Details
Legal Name *
Preferred Name
Date of Birth *

Day Month Year
Gender *

Male Female Other option

Home Address *

Address
Address Line 2
Town	County
Postcode	Country

Date of Admission *

/ Day / Month Year
Date
Previous School *
Other School
Please state if not listed above
Siblings currently attending Lightcliffe Academy
Year and Form of sibling

Parents or Carers who have legal responsibility to the child
1. Parent/Carer *

Title
Relationship to child *
Parent/Carer serves in the Armed Forces *

Yes No

Address (if different to child)

Address
Address Line 2
Town	County
Postcode	Country

2. Parent/Carer

Title
Relationship to child
Parent serves in the Armed Forces

Yes No

Address (if different to child)

Address
Address Line 2
Town	County
Postcode	Country

Parent/Carer living at an address different to the child who wishes to receive:
Please select appropriate

Student Report Text Messages/Emails
Relationship to child

Emergency Contact Information

Please note that the Academy text messaging/emailing system uses the primary number of the first contact
First Contact *

Title
Relationship to child *
Home Number
Mobile Number
Work/Other
Email
Second Contact

Title
Relationship to child
Home Number
Mobile Number
Work/Other
Email
Third Contact

Title
Relationship to child
Home Number
Mobile Number
Work/Other
Email
Fourth Contact

Title
Relationship to child
Home Number
Mobile Number
Work/Other
Email

Ethnic Background
Our ethnic background describes how we think of ourselves. This can be based on many things, including, for example, our skin colour, language, culture, ancestry or family history.
Ethnic background is not the same as Nationality or Country of Birth.

The Information Commissioner’s Office (ICO) recommends that young people over 11 years old have the opportunity to decide their own ethnic identity. Parents/Carers with Parental Responsibility are asked to support or advise those children aged over 11 in making this decision, wherever necessary. Students aged 16 years and over are able to make this decision for themselves.

You have a right to decline to provide data on Student Ethnicity, First Language, Country of Birth and Nationality and to retract the data where previously submitted.
This can be done by contacting the school office using contactus@lightcliffeacademy.co.uk or in writing to our postal address.
Ethnicity *
Country of Birth *
Nationality *
Religion *
Home Language *
First Language *
English as Additional Language *
If yes, please state Proficiency in English below
Proficiency in English Language
Please sign below to indicate whether this part of the form was completed by a Parent/Carer, the child or both.
Ethnic/Cultural Background - Parent/Carer E-Signature *

Clear
Or Ethnic/Cultural Background - Student E-Signature *

Clear

Parent/Carer Permission for Photographs/Video
As a safeguarding measure, all students are photographed on entry into the Academy for identification purposes and to create an Identity/Cashless Catering card.

Periodically, it is also necessary to photograph or record students for educational purposes. For example, where students are following some GCSE courses, we may need to record them on video as part of the evidence for the examination. In these circumstances, the images are securely stored, used only for those purposes, and are only shared with others where we are legally allowed to do so.

From time to time, we also take photographs and videos of students to showcase what our students do in school and to celebrate their success and achievements. We use these images in the school’s prospectus and newsletters, on the school’s website and social media platforms, on display boards around school and occasionally in the external press and media e.g. newspapers and television.

We really value using images of our students in these ways and would like your consent to do so. If you’re not happy for us to do this, that’s no problem – we will accommodate your preferences.

If you change your mind at any time, you can inform us of this change by emailing us contactus@lightcliffeacademy.co.uk or in writing to our postal address.

If you have any questions about the consent you are giving, please do not hesitate to contact us.

Please tick the relevant boxes below.
I consent to images of my child being used on the school website I consent to images of my child being used in the school prospectus I consent to images of my child being used in internal displays and presentations I consent to images of my child being used in the Principal's Newsletter I consent to images of my child being used on the school's social media platforms I consent to images of my child being used in the external press and media
Parent/Carer E-Signature: *

Clear

Parent/Carer Consent for Fixtures and Sporting Events
During your child’s time at Lightcliffe Academy in Years 7-13, they may be asked to participate in off-site sporting events, fixtures, competitions or performances.

In order for us to ensure the health and safety of your child whilst taking part in Sporting Events, we ask that you complete the below information to cover the duration of your child’s time at Lightcliffe Academy.

Without this consent, your child will not be able to participate in any of these off site activities.
I,

Parent/Carer Forename Parent/Carer Surname
agree that:

Student Forename Student Surname
Can participate in sporting events and off-site physical activities whilst at Lightcliffe Academy and I understand my child will be issued with full details prior to every fixture/event Can be transported in the school minibus or private coach if necessary Is in good health and fit to participate in the activities described Can receive First Aid treatment if required
Fixtures/Sporting Events - Parent/Carer E-Signature:

Clear

Please use this space to add any additional information about you and your child.
Please add an email address if you require a submission confirmation
example@example.com
Submitted by *
Enter the text as shown below *
Should be Empty:

Street Address
Street Address Line 2
Town	County
Postcode	Country

Student Details

Parents or Carers who have legal responsibility to the child

Emergency Contact Information

Medical Information

Ethnic Background

Parent/Carer Permission for Photographs/Video

Parent/Carer Consent for Fixtures and Sporting Events