LPO SEND Questionnaire 2026

Please register each child separately, using this form once per child.

Thank you.

Child Details

Child's First Name

Preferred First Name (if any)

Child's Last Name

It really helps our team to have a photo of the registered person.

Please note that the maximum file size is 1Mb and the maximum resolution is 2500 x 2500 - you may need to change the picture size if using mobile phones to take the picture.

Photo

Parent / Carer Full Name:

Email Address

Verify Email Address

Mobile including international code

Alternative on-site contact number:

We will do everything we can to try to cater for the needs of the person you are registering. The more information you can give us, the more likely we are to be able to help. However, our resources are finite, and the availability of team with the skills required is also a limiting factor, so we may not be able to meet the needs of every person, and we are not able to offer one-to-one support. At first, if the person's needs are complex, we may ask you to stay with them until the team is confident that they have settled, or until the leaders are satisfied they can provide good care.

For more information regarding additional support please see the accessibility page on our website.

https://springharvestholidays.com/le-pas-opton/accessibility

Please tick any needs that apply to the person you are registering (or none) - additional data will be requested if required.

None

A diagnosed physical or additional need

A suspected physical or additional need

Health condition that may impact their participation

May require medication

Not a native English speaker

Have emotional/social/sensory needs, trauma or previous bereavement that we should be aware of.

Identify as transgender, genderfluid or non-binary and have preferred pronouns we should be aware of

Other (a field will appear for you to enter information)

Additional Needs:

Please help us to understand the needs of the person you are registering and how we may be able to help them access the programme.

Please tick all that apply then complete any of the questions that appear.

A physical disability

A hearing impairment

Visual impairment

Autism

ADHD or ADD

PDA

OCD

Global development delay

Learning disability

Anxiety

Dyslexia

Auditory processing disorder

Dyspraxia

Epilepsy

Other

Hearing impairment - Details

My child has difficulties hearing and instructions may need to be repeated

My child is deaf

My child uses a hearing aid

My child uses Makaton/BSL (please give more details below)

Other hearing needs (give details).

Please tick any of the following that apply:

Is non verbal

Is selectively mute

Uses Makaton

Needs a visual timetable and now/next boards

Is a 'runner'

Can get physical when escalated

Can hide when escalated

Can get verbally aggressive when escalated

Needs some level of help in the toilets

Uses nappies

Needs movement breaks

Cannot tolerate physical touch

Is sensitive to noise

Appreciates deep pressure/physical touch to calm down

LPO SEND Questionnaire 2026

Le Pas Option - Child Registration Form 2026

Add/Replace Photo

For more information regarding additional support please see the accessibility page on our website.https://springharvestholidays.com/le-pas-opton/accessibility

Your Browser Settings have Cookies Disabled

For more information regarding additional support please see the accessibility page on our website.

https://springharvestholidays.com/le-pas-opton/accessibility