Educational Guardianship Proforma – Parents

Full name of pupil *

Known as

House *

Name of Guardianship Agency/Guardian: *

Address of Guardianship Agency/Guardian: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home phone of Guardianship Agency/Guardian

Work phone of Guardianship Agency/Guardian

Mobile phone of Guardianship Agency/Guardian

Email *

Authorisation *

The above named person/agency is authorised by me to undertake the following responsibilities for my son/daughter throughout the time that they are attending the School, or until I authorise that the situation has changed:

To provide a point of contact on a daily basis throughout the School term and be ready to accommodate my son/daughter in case of an emergency or crisis or in the unfortunate event of their being suspended from school.
To collect and deliver pupils to and from airports at half terms, beginning and end of term.
To collect pupils from School for the exeat weekends / half term holidays / longer holidays and to provide an appropriate degree of care and supervision during that time.
To make suitable alternative arrangements if unable to accommodate my son/daughter.
To be involved in each and every arrangement for my son/daughter when residing away from School, for example when visiting the family of another pupil or friend.
To communicate all such travel details in writing with the Houseparent and to provide all necessary details prior to my son/daughter leaving School for longer holidays.
To be ready to attend important parents’ conferences or other important meetings at the School on my behalf.
To communicate with Houseparent on a regular basis regarding the welfare of my son/daughter.

Confirmation of Suitability *

I confirm that the above named person is over 25 years of age, is resident in the UK and is English speaking. This person is not a full time student living in accommodation provided by another education institution.
I confirm that the above named agency will provide my son/daughter with a guardian who is over 25 years of age, resident in the UK and is English speaking. This person will not be a full time student living in accommodation provided by another education institution, and will not be a member of staff at Wells Cathedral School.

Changes to Guardianship *

I also undertake to notify the School in writing of any change of guardian or of guardianship agency and to provide contact details of the new guardian or agency.

Terms and Conditions *

I accept the School’s terms and conditions as laid out in their Guardianship Policy document regarding the appointment of a guardian for my child.

Correspondence *

I agree to my child’s guardian receiving a copy of my child’s school report/correspondence.
I do not agree to my child’s guardian receiving a copy of my child’s school report/correspondence.

Name of Parent(s) *

Signature(s) *

Clear Signature

Date *