Confirm Information

Your student trip is just around the corner and Coded welfare team wants to make sure everything runs smoothly. We kindly request you confirm the following information

STUDENT INFORMATION

School

Student Full Name:

Date of birth:

Blood type:

NEXT OF KIN CONTACT (in case of emergency)

Full Name

Relationship:

Email address:

Contact number:

MEDICAL INDICATIONS

Does your child take any medication, supplements or vitamins?

Please provide detailed information, including how long they have been taking the medication and the dosage.

Is your child allergic to any medication?

Please provide detailed information.

Has your child had any recent surgery?

Please provide detailed information.

Does your child have a chronic illness/disease that requires us to take into consideration for his/her care?

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Has your child ever experienced panic attacks, anxiety, clinical depression, bullying, or any other challenges that we should be aware of in order to provide extra care for him/her?

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Does your child have autism, Asperger's syndrome, or other conditions within the autism spectrum?

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Has your child ever experienced any significant behavioral challenges in school or other structured environments (e.g., difficulty following rules, defiance of authority, or ongoing disciplinary concerns)?

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Has your child ever been involved in any incidents involving school disciplinary action (e.g., suspension, expulsion, or formal warnings)?

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Is there anything else you would like us to know about your child’s behavioral history or temperament that may help us better support them during their time in the program?

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Has your child ever been involved in incidents of physical or verbal aggression toward peers, teachers, or other authority figures?

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Has your child ever been reported for bullying behavior (in person or online), including verbal, social, or physical bullying?

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Is there anything else related to your child’s social behavior that you believe we should be aware of to ensure a safe, respectful, and inclusive environment for all participants?

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Does your child require any specific assistance with mobility? If yes, please provide as much detail as possible.

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Please share any vital information you believe is essential for us to know but has not yet been covered in our previous inquiries.

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Is there anything else that we would need to know about your kids medical and health history?

FOOD ALLERGIES

Does your child have any food allergies? If so, please provide as much detail as possible. Specifically, let us know which allergens they cannot consume, the type of reaction they experience, and whether they take any medication to manage their allergies.