Outreach Consent Form

Rowan Gate

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

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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 *

Contact Wilby

Rowan Gate at Wilby
Church Lane
Wilby
NN8 2UG
Head of Provision - Maxine Anthony-Hill

Tel: 07399328028

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+