Student Details

Name*

Gender*

Male Female

Date of Birth*

Year Group*

Password*

Sibling(s) Enrolled?

Yes No

Parent(s) / Guardian(s) details

Mother*

Father*

Full Address*

Contact Number*

Email*

Medical History

Emergency contact*

Emergency contact phone number*

GP Name*

Full Address*

Contact Number*

Email*

Does your child have any medical conditions?

Yes No

Does your child have Special Education Needs (SEND)?

Yes No

Type of condition:

Medication given and dosage:

Do you consent to pictures being taken of your child/ children for marketing and promotion purposes (this will include printed materials and social media)?

Yes No

Parent / Legal Guardian Name

Date of registration*

Signature

Alas tutors student registration form

Student Details

Parent(s) / Guardian(s) details

Tuition details and fees

Medical History

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Alas tutors student registration form

Student Details

Parent(s) / Guardian(s) details

Tuition details and fees

Medical History

Our trusted partners

Quick links

Support

Contact information

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