Child's name
Hebrew name
Date of birth
Parent's name/s
Address
Home telephone
Parent/s mobiles
Email address/es
Day school
Emergency contacts (other than parents who are members of FRS)
Name & relationship
Phone number
Name & relationship
Phone number
Doctor’s Details

I/we give consent for photographs of my/our child to be published in the FRS Tree of Life magazine or Kochavim publicity. YES/NO

I/we give consent for photographs of my child to be displayed on the FRS website and on Facebook and Twitter.

YES/NO

By enrolling your child, you agree to sharing your contact details with other parents in order to facilitate swaps for security duty, car pooling, Year group socials and other such reasons as they arise. If you do NOT wish your contact details to be shared, please contact Rachel Fidler on

FRS and Kochavim Behaviour Policy

Please see the enclosedBehaviour Policy, which we are asking all children to abide by and parents to work with us to apply. Please make sure the Parent/Guardian and child sign below.

We, ______, the parent/guardian and ______, the prospective Kochavim chanich/a, hereby commit to abiding by the FRS and Kochavim Behaviour Policy.

Signed:______[Parent/Guardian] ______[Child]

Kochavim Medical Form

1.Does your child regularly suffer from any of the following?

Condition / Y/N / Comments
Asthma
Hayfever
Vomiting or diarrhoea
Migraines
Other ……………………………

2. Does s/he have a Statement of Special Educational Needs or Disability?

Does your child have any special needs?

Y/N / Details
Learning
Behavioural
Sensory
Other

3.Does your child have a Special Need that would affect them enrolling in a particular course? If so, what kinds of activities should we at Kochavim be aware of?

4. Does your child take any medication on a regular basis?: If so, please give details together with the dosage requirements:

5. Does your child suffer, or has s/he ever suffered from fits or epilepsy in any form?:

If yes, please give details:

6.Has your child any known sensitivities or allergies? If so, please give details:

Are there any other (health/medical/social issues) that you think would be important for us to know about your child?

Is there any family situation or background you think would be helpful for us to know about? (e.g. divorce, adoption, a recent bereavement or emotional difficulties).