Parental Consent Form Young Learners in a Group (12-17)
We want to make sure that your child is safe and happy while studying in the UK. To help us, we ask
you (the parent or legal guardian) to complete this form for any student aged under 18 who isenrolled at Nacel English School London
Please note that the student will not be able to start the course until we have received the form.
Data Protection
We promise to keep this information secure and will only give it to people who are directly involvedin caring for your child on a need to know basis during the time when they are enrolled at Nacel
English School London; this may include healthcare and welfare professionals.
Student Details:
First Name:

Surname:

Date of birth:

Nationality:

Passport Number:

Passport expiry date:

Gender:Male/Female

First language:

Parents’ or Guardian’s Details:
1.
Title:First name:

Relationship to child:

Family name:First language:

Level of English:

Address:
Mobile phone:

Email:

2.
Title:First name:

Relationship to child:

Family name:First language:

Address:
Mobile phone:

Email:

Level of English:

English Course
I give consent for my child to travel to the UK and study at Nacel English School London.
I understand that:• if my child is aged 12-15 they will study in closed groups only with students who are thesame age. However, they may come into contact with students over the age of 18 whilst inthe school.
• If my child is aged 16-17 they will study with adult students aged 18+.
YES □ NO □Travel
I give consent for my child to travel to the UK and study at Nacel English School London.
I agree that my child can travel unaccompanied:• between the school and his/her accommodation*.
• from Central London to his/her accommodation (aged 16-17 only**)

YES □ NO □*Typically homestay accommodation is a short walk, bus ride or tube journey from the school.
Typical travel time is between 5 and 30 minutes.
**A Nacel Member of staff or the group leader will accompany all students aged 12-15 back toschool after visits to Central London.
Accommodation
I agree to my child staying in homestay accommodation arranged by Nacel English School London.
I understand that Nacel English School will not allow my child to stay overnight with friends orarrange a holiday with friends.
I understand that Nacel English School will require written permission should my child wish to movefrom supervised homestay accommodation to one that has not been organised by the school. Theschool will also have to receive full details of the new accommodation before this is approved.
I confirm that my child will abide by the host family rules and regulations; use of the TV, and landline;
smoking; use of the bathroom; cleanliness and tidiness; meal times; safety and security; having
guests and noise.
I understand that my child is responsible for any damage they may cause in the host family
accommodation and will therefore be liable for any damages.
YES □ NO □Curfew Times
Nacel English School have curfew times for all students aged 12 to 17. The curfew time is the timethat students must be back in their accommodation.
Students aged 12-15
Students must return directly to their homestay accommodation after their classes/activities havefinished.

Students aged 16-17
Sunday to Thursday - 10:00pm
Friday to Saturday - 11pm
I agree that my child will abide by the curfew times set by Nacel English School London.
YES □ NO □Alternatively, if you wish your child to be home earlier in the evenings please indicate the timebelow.
Time to be home: Day(s)………………………………………………….. Time (s)…………………………...……………………..

Leisure Activities

I give permission for my child to go on the trips/ activities according to their timetable with amember of Nacel English School staff and/or Group Leader.
YES □ NO □I give permission for my child to have free time for shopping on trips arranged by the school. Freetime will be limited to an hour within a specified area and students will be in groups of at least 4.
YES □ NO □Unsupervised TimeI understand that my child will have unsupervised free time from when classes/activities finish until
they return to their accommodation (see above for curfew times).

MedicalPlease tell us about any medical problems. If we are not told in advance about a physical or mental
condition, we reserve the right to terminate the student’s course.
Does your child have:
Asthma or bronchitis

YES □ NO □Heart condition

YES □ NO □Fits, fainting or blackouts

YES □ NO □Severe headaches

YES □ NO □Diabetes

YES □ NO □Allergies to known medicines

YES □ NO □Other allergies e.g. materials, food, plasters

YES □ NO □Travel sickness

YES □ NO □Bed-wetting/incontinence

YES □ NO □

Any mental health problems?
(including eating disorders, hyperactivity)

YES □ NO □Is your child on regular medication?

YES □ NO □Does your child require regular hospital treatment?

YES □ NO □Does your child take any medication which he/she will bring with them? YES □ NO □Is there additional Information we should know about?

YES □ NO □If the answer to any of the questions above is YES, please give details:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
In case of minor pain or illness such as a headache, mild cold or sore throat, do you
agree to your child being given non-prescription medication such as
Paracetamol, cough medicine, throat pastilles, antihistamine or travel sickness tablets?
YES □ NO □In case of an emergency do you give permission for a responsible person in Nacel English School
London or the Group Leader to arrange medical treatment for you child. (E.g. be seen by a doctor orhospitalised)
Of course, every effort will be made to contact you, the child’s parents/guardians, as quickly aspossible.
YES □ NO □AttendanceStudents are expected to attend all scheduled classes and activities and to be in theiraccommodation at the stated times. If you wish your child to be absent from the course at any time,please contact the Nacel English School London directly so that suitable arrangements can be made.

Photographs and Video Clips
I understand that the Nacel English School London may take photographs or video clips of studentsduring class or leisure activities and that these images may be used in the school’s publicity or on its
social media site.
I consent for images to be taken and used for the schools following publicity:• Internal printed advertisements e.g. posters within the school• External printed advertisements e.g. pricelist or brochures• Social media e.g. Facebook, Instagram or YouTube• The School Website

YES □ NO □YES □ NO □YES □ NO □

ConsentI confirm that the above details are accurate and complete, and that I agree to the terms andconditions.
I have discussed the agreed arrangements and rules with my child.
Signature of the parent/guardian:…………………………………………… Date: ……………………………………………

I have discussed the agreed arrangements and rules with my parent/guardian.
Signature of the student: …………………………………………… Date: ……………………………………………