Leave of Absence for Pupils

Pupil Name*

Tutor Group*

Are you requesting leave of absence for any other children at Kettlethorpe High School?*

YesNo

If yes, please state their name(s) and tutor group

Are you requesting leave of absence for any other children not at Kettlethorpe High School?*

YesNo

If yes, which school do they attend?

Please state what day(s) your leave of absence is for*

Please put in dd/mm/yy form

Total amount of days absent from school*

Please put in dd/mm/yy form

Name and address of who they are travelling with*

Please add in the relationship to the pupil

Reason for absence*

Medical / dental appointmentPersonal (inc. compassionate leave etc.)Religious ObservanceAttending Interview (college/apprenticeship)Sporting Event (outside of school)Performance (please email attendance a copy of the licence)Other

Please share more details below:*

Does the form overlap with the beginning or the end of term?*

YesNo

GUIDANCE
The law states that parents do not have a right to take their child out of school for a holiday during term time as it
can disrupt their education. Only in exceptional circumstances may a head teacher grant permission for leave of
absence.

Legal responsibility
As a parent/guardian I understand all children aged between 5 and 16 are required by law to receive an education
and under the provisions of the Education Act 1996, it is my responsibility as a parent to ensure the regular
attendance of my child/children. Failure to do so could result in legal proceedings being taken by the Local Education
Authority.

The Headteacher will consider the following points before authorising leave:
1. Whether the request fits the ‘special circumstances’ criteria outlined by Government legislations
2. The pupil’s attendance history
3. The time of year (no requests will be granted at the start or end of an academic year, during exam time or for
any pupil in Year 10 or 11)
4. The family circumstances and the reasons for wanting to take their annual family holiday during term time

Penalty Notice:
Parents who choose to take their child/children out of school without written permission from the school may be
issued with a fixed penalty fine.

Signature*

Name*

First NameLast Name

Your email address*

Please use the email address linked to your child on the Kettlethorpe High School System.

Date of form completion*

By clicking submit I understand that I may not get a specific reply to my individual request.

Leave of Absence Request