Medical form

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Medical information required for juniors studying at St Brelade’s College

St Brelade’s College has a legal duty of care to look after under 18s safely. In order to do so, we require that parents/guardians provide emergency contact details and medical information for every child. Please provide this information using the form below.

* Indicates required fields

    Emergency contact details

    Does the emergency contact speak English?*

    Health declaration

    If your child has a severe condition which could be life threatening e.g. a serious nut allergy you will not be able to complete the form and should contact the office directly for advice.

    I confirm that he/she does not have any life threatening conditions.*

    Does he/she have a special diet? e.g. vegetarian, vegan, lactose intolerance*

    Has he/she been affected by or requires treatment for any of the following?

    Is there any reason why he/she should not take part in all the normal school sports and activities?*

    Can he/she swim 50 metres?*

    Is your child's Tetanus injection up to date?*

    Do you give us permission to give your son/daughter paracetamol if needed? *

    Do you give us permission to carry out basic First Aid on your child if needed? *

    I agree that the medical information given is correct to the best of my knowledge (6.1.).*

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