Registration form

 

Padstow Pre-school RegistratioForm

School Grounds, Grenville Road, Padstow PL288EX

01841 533244

 

Surname: …………………………………………………… Date of Birth: ………………............

 

Christian Names.................................................................................................................................

 

Home Address: ………………………………………………..........................................................

 

………………........................................................... Post Code: ……...............................................

 

Telephone No: Home………………...............    Relationship to child………………………...

 

Second contact……………………..................       Relationship to child.....................................

 

Third contact…………………………………        Relationship to child.....................................

 

Name & address of Doctor…………………………………………………………......................

 

Parents/guardians names: ………………………………………………………………………..

 

Brothers/sisters names & ages: ……………………………………………………………….....

 

Child’s health: Please give any details of serious illness or conditions which could affect your child’s care i.e. asthma, diabetes, epilepsy, sight or hearing impairments. Please continue on another piece of paper if necessary (sign & date).

 

…………………………………………………………………………………………………………

 

Has your child been immunised against the normal child hood illnesses i.e. measles, mumps etc.? *YES or No

 

Other details: Please give us any information which you feel the pre-school may be able to help your child with i.e. shyness, speech & language difficulties, sharing or behavioural issues etc.

 

…………………………………………………………………………………………………………

 

I give consent for my child to receive urgent medical treatment and for the pre-school to seek urgent medical advice if it is deemed necessary. If the answer is no, please state reason *YES or NO

Does your child attend another pre-school, nursery or childminder? *YES or No

 

Name of setting …………………………………………………     Do you give permission for us to contact the other setting and exchange information? *YES or NO

 

Special times & festivals: Do you celebrate any specific religious or cultural events that you would like us as a group to celebrate with your child?

 

…………………………………………………………………………………………………………

 

Rota duty: We do not operate a parent rota duty, but you are welcome to stay and help if you wish.

Payment of fees & attendance: Fees will not fall more than 2 weeks in arrears. If this happens the management team has the right to withdraw your child’s place until all outstanding fees are paid in full. Please ask about funding options available for your child. We respectfully ask you to ring us and let us know if your child will not be attending the session they are booked in for and why they will not be attending. If you do not inform us, you will be charged for that session. As a condition of receiving EY funding, the children’s attendance records are audited by the local authority.

 

I give permission for my child to have sun cream applied. Please tell us if they are allergic to any brand *YES or NO

 

I give permission for my child to be taken on supervised walks at the pre-schools discretion. Please note it may not always be possible to notify you which days they will be taking place *YES or NO

 

Do you give consent for your child to be photographed/videoed as part of our daily observation routines and for publicity/marketing purposes? (No names will be printed)

*YES or NO

 

Signed…………………………………………………………….......................Parent/guardian

 

Date: ………………………………………………………………………………………………..

 

Email address: …………………………………………………………………………………….

 

 

 

              

 

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© Julie Nicholls