To ensure we can provide the best possible experience and guarantee the safety and well-being of all participants, we require the information requested in this form. All fields are mandatory and must be completed accurately.

By submitting this form, you confirm that you have read and accepted our Privacy Policy

Formulario de Información del Estudiante – Programa de Inmersión Académica en Wells Cathedral School

Para garantizar la mejor experiencia posible y velar por la seguridad y el bienestar de todos los participantes, requerimos la información solicitada en este formulario. Todos los campos son obligatorios y deben completarse con exactitud.

Al enviar este formulario, usted confirma que ha leído y aceptado nuestra Política de Privacidad

Choose your language / Elige tu idioma

Student information

Full name

Date of birth

Nationality

Passport number

First language

School

Gender

Male Female Other

Address

Guardian 1

Full name

Relationship

Father Mother Other

ID (DNI)

Phone number

Guardian 2

Full name

Relationship

Father Mother Other

ID (DNI)

Phone number

Medical information

Blood type

O+ O- A+ A- B+ B- AB+ AB-

Any medical conditions?

No Yes

If yes, please describe. If medication is required, declare it here.

Any allergies?

No Yes

If yes, please describe.

Any dietary restrictions?

No Yes

If yes, please describe.

In case of emergency, I authorize medical, dental and optical treatment to be administered (Note: whenever possible, parents will be contacted). *

Yes No

Check the box if you agree that we administer any of the following, if necessary

Paracetamol Paracetamol suspension Ibuprofen Ibuprofen gel Ibuprofen suspension Throat sweets Sore throat gargles Antiseptic cream Burns treatment Bites and stings cream Homeopathic cream for bruises and swelling Antihistamine tablets Hypoallergenic plasters

Media Authorizations

I give consent for school photographs that contain my child to be used in promotional material as long as the images do not bear any identification of the individuals portrayed.

Yes No

I give consent for school videos that contain my child to be used in promotional material as long as the videos do not bear any identification of the individuals portrayed.

Yes No