Outreach Consent Form

Primary School

Finedon Rd, Wellingborough, Northants, NN8 4NS
Tel: 01933 304970
Strategic Head Teacher - Laura Clarke

Hayway, Rushden, NN10 6AG
Tel: 01933 351200
Strategic Deputy head - Julia Coles
Satellite Classes, See Footer

Consent for Specialist Observation

Please read each section of this form and sign the relevant sections. For further information please contact your child’s SENCo with any questions.

Date / Time *

School name: *

Child's Name *

Child Date of Birth: *

Parent or Guardian Name *

Relationship to Child *

Consent for Observation

I consent for {field.ChildName) to be observed by a Senior Teacher from Rowan Gate Primary school. My child’s details and observation notes will be held in accordance with the Data Protection Act (2018) and the General Data Protection Regulation (2016)

Signature *

Name of Person Signing *

Consent for Sharing of Data

Consent to share and receive information with other relevant professionals; I agree that the Senior Teacher can make contact and share and receive information (verbally and in writing) with other professionals involved with my child/young person.

Signature *

Name of Person Signing *

Name

Contact The Hayway

Rowan Gate East, Hayway
Rushden, Northants
NN10 6AG
Head of Provision - Sue Morris

Tel: 01933 351200

Contact Finedon Road

Rowan Gate Finedon, Finedon Rd
Wellingborough, Northants, NN8 4NS
Acting Head of Provision - Nicole Lawson

Tel: 01933 304970

Satellite Classes #1

Rowan Gate, c/o Tennyson Road Infant School,
1 Highfield Road, Rushden, NN10 9QD
Head of Provision - Maxine Anthony-Hill

Tel: 07539160502

Satellite Classes #2

Rowan Gate c/o Stanton Cross Primary School,
Waverley Drive, Wellingborough, NN8 1GN
Head of Provision - Natalija Zemcugova

Tel: 07891936540

Rowan Gate Primary School

a community day special school for pupils aged 2+ to 11+