Uppingham School Acceptance Form by uppinghamschool1584

Uppingham School

Acceptance Form

Uppingham School Acceptance Form (Accepting the Offer of a Place) 1. Childâ&#x20AC;&#x2122;s details Surname of your child:................................................................................................................................ First names:(underline preferred name)........................................................................................... Sex M/F:............... Date of Birth: ............ /............ /............ Nationality....................................... Place of Birth (This information is required by some examination boards) Town: ..................................................................... Country: .................................................................... Religion:............................................................................................................................................................. First Language (if not English):.............................................................................................................. Term & Year of Entry: ...................................................... House: ........................................................ Type of place (please tick box):

Boarding

Day

2. Father/Legal Guardian (1) (including title, full names, address and postcode) Title: ........................Surname:....................................................................................................................... First names: (underline preferred name).......................................................................................... Address:.............................................................................................................................................................. ................................................................................................................................................................................ .................................................................................................Postcode:...................................................... Telephone (daytime): .................................................. (evening):....................................................... Telephone (home - if different to evening tel):.............................................................................. Mobile:................................................................................................................................................................ Email:................................................................................................................................................................... Is this address the main residence of your son/daughter?

Yes

Industry:........................................................................Occupation: ....................................................... Employer:..........................................................................................................................................................

Acceptance Form

3. Mother/Legal Guardian (2) (including title, full names, address and postcode) Title: ........................Surname:....................................................................................................................... First names: (underline preferred name).......................................................................................... Address:.............................................................................................................................................................. ................................................................................................................................................................................ .................................................................................................Postcode:...................................................... Telephone (daytime): .................................................. (evening):....................................................... Telephone (home - if different to evening tel):.............................................................................. Mobile:................................................................................................................................................................ Email:................................................................................................................................................................... Is this address the main residence of your son/daughter?

Yes

4. Fee bills will be sent to the signatories on page 6. Please advise us to whom other correspondence should be sent. Both parents/legal guardians jointly

Father/legal guardian (1) only

Both parents/legal guardians separately

Mother/legal guardian (2) only

5. Fee Payer’s Title, Full Names, Address Is it proposed that anyone other than parents will pay or guarantee payment of the fees? Even if the ‘Yes’ box is ticked, the signatories on page 6 remain legally liable for paying fees under section 4.4 of the Terms & Conditions. If the ‘Yes’ box is ticked, the person named will also be sent a copy of the bill. Yes

Title: ........................Surname:....................................................................................................................... First names: (underline preferred name).......................................................................................... Address:.............................................................................................................................................................. .................................................................................................Postcode:...................................................... Telephone (daytime): .................................................. (evening):....................................................... Telephone (home - if different to evening tel):.............................................................................. Mobile:................................................................................................................................................................ Email:................................................................................................................................................................... 3 Acceptance Form

6. Please provide details of your child’s present school. Present school:............................................................................................................................................. Name of Head:.............................................................................................................................................. Address:............................................................................................................................................................ .............................................................................................................................................................................. .................................................................................................Postcode:.................................................... Telephone: ................................................................................................................................................... Email:................................................................................................................................................................. Date started:............................. 7. I/We both have parental responsibility (i.e. legal responsibility) for my/our child (If ‘No’ please give details in a confidential letter attached to this form.) Yes

8. Please tell us if your child has attended any of the following events or courses at Uppingham: Summer School course Prep School Orchestra Day

Skills Day

On the Buzzer

Sports Tournament e.g. U11 six-a-side Cricket Tournament

Acceptance Form

IMPORTANT – Before signing this Acceptance Form you should read (i) the offer letter (ii) the terms and conditions included with this Acceptance Form and (iii) the School Rules. You should draw the School Rules to the attention of your child. We hereby accept the offer of a place at the School for my/ our child (named overleaf) with effect from the beginning of the term indicated in the offer and section 1. We acknowledge receipt of a copy of the current School Rules and agree that we and our child shall observe and be bound by them. Cancellation rights I/We understand that we may cancel this agreement at any time within 14 days of the date of acceptance only if the offer is made and accepted entirely at distance by means of post or electronic communication. Declarations by the Parents I/We declare as individuals and jointly that: 1 Terms and conditions: I/We have read and understood and I/we agree to the School’s Terms and Conditions. 2 Disclosures: I/We have already provided and will continue to provide details of any medical condition, health problem or allergy affecting my/our child; details of any safeguarding matter concerning my/our child; any learning difficulty, disability, or special educational need of my/our child, as well as any behavioural, emotional and/or social difficulty of my/our child (for example dyslexia, dyspraxia, attention deficit disorder, visual or hearing impairment or any condition requiring use of a wheelchair). I/We attach* in confidence details of any relevant information received since my/our previous disclosure. 3 Medical matters: I/We attach* in confidence all relevant information about any medical condition, health problem, or allergy which affects my/our child and/or which may prevent my/our child from taking a full part in the School’s academic and games or sports curriculum and outdoor activities.

(iii) my/our child has the right to enter, live and study in the United Kingdom and, if I/we require the School to sponsor our child as a condition of his/ her entry into the United Kingdom, (a) such requirement has previously been notified to the School; and (b) if applicable, the School is entitled to charge (and we will pay upon request) the relevant administrative fee for its role in the Student and Child Student Visa sponsorship process and/or a British Residence Permit collection fee. 5 Parental responsibility: Each person with parental responsibility for the child is required to sign this Acceptance Form. The School is entitled to treat any instruction, authority, request or prohibition received from one signatory as having been given on behalf of all signatories and therefore on behalf of all those with parental responsibility for the child. An exception to this is with regard to a notice of withdrawal of the child from the School – such notice must be signed by all those with parental responsibility for the child. (See Clause 3 of the terms and conditions.) 6 Current and previous schools: By signing this Acceptance Form I/we confirm that I/we are not (either jointly or individually) in arrears on the payment of any fees or charges owing to my/our child’s current (or previous) school or educational establishment. Authorities given by the Parents I/We give the following express authorities on behalf of myself/ourselves and (so far as I am/we are entitled to do so) on behalf of my/our child. 7 School fees: I/We consent to the School at any time making enquiries of my/our child’s current or previous schools for confirmation that all sums due and owing to such school(s) have been paid and I/we consent to the School informing any other school or educational establishment to which I/we propose sending my/our child if any fees of this School are unpaid. I/We also consent to the School making reasonable enquiries about my/our financial means in appropriate circumstances.

4 Court orders: By signing this Acceptance Form I/we confirm that unless otherwise notified to the School in writing before signing this Acceptance Form: (i) there are no court orders in place in respect of the care or living arrangements of my/our child; * Please use the Confidential Information Form at the end of (ii) any information or circumstances about or the document. relating to me/us and/or my/our child that has previously been notified to the School (including on the School’s online registration form) or otherwise as part of the School’s registration and admissions process) is and remains complete and accurate as at the date when we sign this Acceptance Form; and 5 Acceptance Form

IMPORTANT: when you complete, sign and submit this Acceptance Form and pay the deposit, you and the School enter into a legally binding contract, upon the School’s terms and conditions. If you subsequently change your mind and decide to withdraw your child before he or she takes up their place, you may lose your deposit and be responsible for paying us fees in lieu of notice – see Clause 3 of the terms and conditions for more information about this.

Signature of Parents or Legal Guardians I/ We have arranged a direct bank transfer for: £.......................... as the acceptance deposit; If applicable: £.......................... as the additional (overseas) deposit I/We acknowledge that I/we have read the statements, ‘Declarations’ and ‘Authorities’ detailed. First Signature:.......................................................................................................................................................................................................................................... Please print name in full (please include title and all names):::.......................................................................................................................................... ............................................................................................................................................................................................................................................................................ Date of birth:....................................................... Relationship to the Child.....................................................................Date:...........................................: Second Signature:.................................................................................................................................................................................................................................... Please print name in full (please include title and all names):::.......................................................................................................................................... ............................................................................................................................................................................................................................................................................ Date of birth:....................................................... Relationship to the Child.....................................................................Date:...........................................:

Please return this form and the following Confidential Information Form to the Registrar by post: Uppingham School, High Street West, Uppingham, Oakham, Rutland LE15 9QE or email admissions@uppingham.co.uk.

Acceptance Form

Uppingham School Confidential Information Form All parents are required to fill in this form even if there is ‘nothing to disclose’. All information received in this form will be treated in confidence.

Child’s full name:........................................................................................................................................... Name of parent or legal guardian (1): ................................................................................................ Name of parent or legal guardian (2): ............................................................................................... Please provide us with details of: • any medical condition, health problem, including mental health issues, or allergy affecting your child • any learning difficulty, disability, or special educational need of your child, as well as any behavioural, emotional and/or social difficulty of your child. This will enable the School to consider any adjustments that it may need to make to assist your child to partake in the School’s admissions procedure or when your child enters the School. Please provide us with as much detail as possible in the space below. Where possible, please provide any relevant documentation such as medical reports, assessments etc. ................................................................................................................................................................................ ................................................................................................................................................................................ ................................................................................................................................................................................ ................................................................................................................................................................................ ................................................................................................................................................................................ ................................................................................................................................................................................ ................................................................................................................................................................................

Nothing to disclose. I/We understand that if I/we do not fully disclose all information requested by the School, the School will terminate my/our application for a place with immediate effect.

First Signature:............................................................................................................................................... Please print name in full (please include title and all names): ................................................................................................................................................................................. Relationship to the Child.....................................................................Date:........................................ Second Signature:......................................................................................................................................... Please print name in full (please include title and all names): ................................................................................................................................................................................. Relationship to the Child:.....................................................................Date:....................................... 7

Confidential Information Form

Uppingham School Uppingham, Rutland LE15 9QE United Kingdom Switchboard: +44 (0)1572 822216 Admissions: +44 (0)1572 820611 admissions@uppingham.co.uk www.uppingham.co.uk

Version 10.20 Linked to T&Cs version 09.20

Uppingham School is a charitable company limited by guarantee registered in England and Wales. Company number 8013826. Registered Charity number 1147280. Registered Office: High Street West, Uppingham, Rutland LE15 9QD