StudentRegistration

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HRS Student Registration Form

Harlow Rock School Student Registration Form

All students must complete and submit the following form by 5th September 2025. Failure to do so will prevent us from knowing you are returning, and you may be missed during band assignment.

Student Registration Form - September 2025

Student Name and Contact Information

* Indicates required field

Student Name *

First

Last

Student Email *

Student Mobile *

Your mobile number and email address will be used for communications about Rock School, Bands, and Performances.

Student Details

Your Date of Birth (DD/MM/YYYY) *

School *

School Year *

Instrument *

Student Address

Address Line 1 *

Address Line 2 *

Town *

Post Code *

Parent/Guardian Detail

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Mobile *

Your mobile number and email address will be used for communications about Rock School, Bands, and Performances.

Student Session Availability

Which day are you going to attend? (choose one) *

I'm available to attend Mondays I'm available to attend Fridays I'm available to attend either Monday or Fridays

Student sessions take place during the school year at venue. They start at 6:30pm and finish 9:00pm.

Medical Information

Allergies/Needs *

Doctor *

Doctors Phone Number *

Additional info we should be aware of *

Emergency Contact Name (if different from Parent/Guardian above) *

Emergency Contact Phone Number (if different from Parent/Guardian above) *

Parent/Guardian Consent

Please Confirm that you agree with the following *

I am happy for my child to find their own way home. I am happy for my child to visit the local shops within the immediate vicinity of Harlow Rock School on their own if given permission by an adult volunteer. In the event of an accident, I consent to any necessary medical treatment, including paracetamol or sticking plasters. In an emergency, I consent to treatment by medical health professionals if considered necessary. I give permission for my child to be photographed and videoed for use by Harlow Rock School on social media and promotions. Students will not be identified by name. I give permission for my child to take part in public live performances, live streaming and stream recording. I am happy for my child to attend weekend events.

By ticking the boxes you confirm that you agree with the statement

As the Parent/Guardian of the student please confirm consent to the points to the left by checking the points you agree with.
By ticking the boxes you confirm that you agree with the statement

Parent/Guardian Agreement

Student Code of Conduct *

We agree that the student will abid by the Student Code of Conduct

Parent/Guardian Agreement *

We confirm that the student named above is in good health and capable of participating in the activities at Harlow Rock School.

Submit

See the attached Student Code of Conduct PDF

Student Code of Conduct
File Size:	216 kb
File Type:	pdf

Download File

Harlow Rock School Charity 1117575

[email protected] 07778 402 076