Primary Contact

_{The primary contact is the first person we contact should the need arise. They will also receive all invoices, newsletters and any other correspondence sent by the nursery.}
 

_{Primary contact photograph:}

Secondary Contact (optional)

_{Secondary contact photograph:}

First Emergency Contact

_{First emergency contact photograph:
by providing a photograph you help us to safeguard your child}

Secondary Emergency Contact

_{Secondary emergency contact photograph:
by providing a photograph you help us to safeguard your child}

_{Family password: What's this?}

About Your Child

_{Child's Photograph:}

Medical Contacts

_{Are immunisations up to date?YesNo}

_{Allergies*: you can select multiple allergies, just hold Command or Shift & Click}
---NoneDairySoyaEggsNutsWheatGlutenInsect StingsLatexPenicillinOther

_{Dietary Requirements:}
---PescatarianVegetarianVeganOther

_{Any other dietary information:}

Special Educational Needs

_{Does your child have any special educational needs and/or disabilities?
YesNo}

Session Requirements

_{We are open term time only and our days run from 8:00am – 5:00pm. The minimum attendance for 3yr old is one half day session. The minimum attendance for a 2yr old is two half-day sessions. Free Entitlement Sessions are either 9am - 12pm (3hrs) or 9am - 3pm (6hrs).
 
Please choose from below:}

Start Date:

_{Using Free Entitlement hours? What's this? Yes
Will require Settling In sessions? What's this? Yes
Do you want your child to have a Nursery lunch (at £2.50 per lunch) instead of providing your own nut-free packed lunch?Yes}

Parental Consent

I give permission for (please tick):

_{— My child to be taken to the doctor / hospital in case of emergency
I accept
— My child to be observed by staff to complete learning stories and track developmental progress
I accept
— My child to have nursery sunscreen applied
I accept
— My child to have Sudocrem applied on an as needed basis
I accept
— My child have their temperature taken should they be showing signs of fever
I accept
— My child to be given Calpol as a first aid procedure to reduce a fever.
I accept
— My child to be photographed at the nursery for their records
I accept
— My child’s photos and videos shown on the website
I accept
— My child’s photos and videos shown on social media
I accept
— My child’s photos and videos used for advertising for the nursery
I accept
— My child’s photos and videos used for talks and presentations
I accept
— The nursery share my contact details with other parents
I accept
— The staff to work with other professionals and share information regarding my child’s well-being and development (i.e. support teachers, schools, other childcare providers)
I accept
— The nursery to contact me via email and phone. (You may withdraw your consent at any time by contacting the nursery.)
I accept}

_{Once form is completed, we'll send you all the details you need regarding Settling In sessions and Holiday Clubs.
 
Childcare Voucher Name:}

_Message:

_{I have read the terms and conditions and policies and agree to abide by their contractual terms.*
I also certify that I am the person with parental responsibility for the above named child.*}