New Rossall Summer School Application Form 2026

STUDENT INFORMATION
Student's Full Name:

First NameLast Name
Birth Date:

MonthDayYear
Sex:
Nationality:
Place of Birth:
First Language:
Passport Number:
Place of Issue:
Number of years studying English:
Current Level of English:
Please upload a copy of your passport.

pdf, doc, html, zip, mp3, avi, jpg, png etc.
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Please upload a recent copy of the pupil's school report.

pdf, doc, html, zip, mp3, avi, jpg, png etc.
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PARENT INFORMATION
Biological Parent/Legal Guardian 1 details:

PrefixFirst NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:
Mobile Number:
Fax Number:
E-mail:
example@example.com
Occupation:
Please upload a copy of your passport.

pdf, doc, html, zip, mp3, avi, jpg, png etc.
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Biological Parent/Legal Guardian 2

If the student is no longer in contact with biological parent 2, please provide an additional contact.
Biological Parent/Legal Guardian 2 details:

PrefixFirst NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:
Mobile Number:
Fax Number:
E-mail:
example@example.com
Occupation:
Please upload a copy of your passport.

pdf, doc, html, zip, mp3, avi, jpg, png etc.
Cancelof

Rossall Student Declaration, Rules and Drugs Policy

Rossall Rules

All Rossall Sumer School pupils must:
1. Fulfil all Rossall Summer School commitments: lessons, games, meals, extra-curricular activities etc.
2. Treat each other, all members of the Rossall Community, and all members of the public with respect, courtesy and consideration.
3. Takes care of all personal property, that of others, as well as their own, and of the fabric of Rossall.
4. Show respect for, and give all possible assistance to visitors, as has always been the tradition for Rossall.
5. Be conscious at all times that the good name of Rossall is in their hands, and that their conduct must be a credit to Rossall.
Whilst a member of Rossall, pupils may not:
- Smoke nor have possession of any smoking materials
- Consume nor have possession of any illegal substance
- Consume nor have the possession of any alcohol, without due authority
- Use nor have possession of a firearm or other weapons, ammunition or any explosive substances, including fireworks
- Engage in gambling
- Use nor have possession of the property of another pupil without the willing permission of the owner
- Buy or sell property, nor borrow money, without the permission of the Houseparent(s)
- Indulge in personal relationships of a physical nature with another pupil
Signature of the student
Date
Student's Name

First NameLast Name
Birth Date:

MonthDayYear

Rossall Drugs Policy

Statement of Policy

It is Rossall policy that it shall actively discourage the use of controlled drugs and shall treat all cases of use by its pupils or staff as serious misconduct.

Implementation of this policy

Where a member of staff suspects that a pupil is using a controlled drug, or there is evidence of equipment used in connection with the use of such substances or there is information which indicates such use, the matter will be investigated by the Summer School Director.

After considering the evidence, the Summer School Director, or a delegated representative may require the pupil to take a urine test. This test shall be carried out in accordance with a strict procedure and takes place in the school medical centre under circumstances of the strictest hygiene and care, whilst still maintaining the privacy and dignity of the pupil. The sample shall be submitted to an independent laboratory for testing. A second sample will be available, on request, for re-testing by another laboratory, if required, by the parents.

Discipline following misuse

If the test is positive, the Summer School Director will exercise their discretion as to whether the pupil will be allowed back to school after a period of suspension. If the pupil is re-admitted, it will be on the express understanding that random testing will occur. Any second offence will lead to immediate and permanent exclusion.

Any pupil caught in the possession of or using controlled drugs or being in possession of them with intent to supply shall invariably be expelled.

The above is a summary of the Rossall Drugs Policy Document: a full copy of this document is available on request. As a Condition of Acceptance, parents are required to sign the following form when applying to Rossall Summer School.
Student's Name

First NameLast Name
Parent 1 Name

First NameLast Name
Signature of parent 1
Date
When the pupil is over 16 at the beginning of term, or will become 16 during the term, the pupil's consent is also required to the following statement.

Student Declaration
Signature of the student
Date

Image Release

By agreeing to the School's terms and conditions, you consent to photographs and digital images of your child being used in the publications produced by Rossall School.

You agree that they will be used for educational purposes only and that no information will be revealed concerning the child's identity (other than reference to their full name, age, residential district and/or year group where relevant).

You agree that the images may also be used in, and distributed by, media other than printed publications such as, but not limited to, DVD, the World Wide Web, press releases and advertising pertaining to Rossall's activities.

PHOTO AND VIDEO RELEASE - Please indicate below how we can use your child's image

Rows	Yes	No
My child can be used in printed material
My child can be used on the website
My child can be used on social media
You can name my child (First name only)

Child's Name

First NameLast Name
Parent's Name

First NameLast Name
Signature of parent 1
Date

Payment

Declaration

An registration fee of £125 will be required to secure a place on the Summer School. This is in addition to the fees and is non-refundable. The fees for the course are due one month before the start of the course and will be invoiced. Please note, you will be sent through to World Pay to complete the booking when you submit this form.

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Summer School Registration Fee

£125.00

Total

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Parent's Name:

First NameLast Name
Signature of parent 1
Date:

MonthDayYear
Please note the offer of a place is subject to availability, the entry requirements at the time and the standard Terms and Conditions of Rossall School. Cancellation of a Summer School place requires a notice period of ONE MONTH. Refunds cannot be issued for places cancelled less than a month before the first day of residency.
Finally, how did you hear about the course?
Please state the name of your agent
Should be Empty:

STUDENT INFORMATION

PARENT INFORMATION

Biological Parent/Legal Guardian 2

Rossall Student Declaration, Rules and Drugs Policy

Rossall Rules

All Rossall Sumer School pupils must:

Whilst a member of Rossall, pupils may not:

Rossall Drugs Policy

Statement of Policy

Implementation of this policy

Discipline following misuse

Student Declaration

Image Release

Payment

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