Consent form for parents/guardians for students aged 16 and 17

I have read the information relating to students under 18 years old and hereby authorise my child to enrol on a General
English course at United World School of English. I authorise my child to join classes with over 18s.
Students full name: __________________________________________________________
My child will stay in a homestay provided by United World

YES

NO

My child will stay in accommodation arranged by my agent

YES

NO

My child will stay with a guardian while in the UK

YES

NO

Please provide the full contact details of the UK-based guardian where the child will be living:
Full Name of guardian ________________________________ Relationship: ___________________
UK Address: _____________________________________________________________________________
Telephone number (24hrs): ___________________________Email: _____________________________

All students under the age of 18, MUST use an airport transfer (both ways) if they are not being picked up by an
adult/guardian.
Name of adult/guardian & contact number whilst travelling:________________________________

_________________________________________________________________________________
If staying in a home stay, does your child require full board?

YES

NO

If not, please confirm what provision you have made for your child for lunch. __________________________
Do you authorise your child to take part in activities which are not included in
the package and may also include over 18s?

YES

NO

Do you authorise United World to give and seek medical treatment where necessary?

YES

NO

Does your child suffer from any allergies or illnesses that we should be aware of?

YES

NO

Is your child on medication? If so, please state which ones:_____________________

YES

NO

Do you authorise your child to ride a bicycle in the UK?

YES

NO

Our curfew is 10.30pm. If you prefer an earlier curfew, please advise: _______________________________

Photographs and videos

We occasionally take photographs and videos during school trips and activities. These are taken with only a school
camera/camcorder and used on our School Website, Facebook page and the school activities notice board. If you
permit us to use photographs of your child/children, please confirm below.

United World may take photos/videos of my child/children. I understand that these photographs/videos will be used
under strict safeguarding guidelines.
I permit

I do not permit

United World may use photos/videos of my child/children on the activity notice board, official website and Facebook
page. I understand that these photographs/videos will be used under strict safeguarding guidelines.
I permit

I do not permit

Comments: _____________________________________________________________________________
____________________________________________________________________ ____________________

Parent/guardian full name:________________________

Relationship: ___________________
Telephone number (24hrs): __________________
Email: ______________________________

Signature:

___________________________ Date: _________________________