Your Child's Details

To submit data about a child, you must have parental responsibility for them. We take data protection seriously. See our website Privacy Policy for further information.

Details of Doctor

Details of Health Visitor

Details of Parent/Guardian 1

Details of Parent/Guardian 2

Details of Emergency Contact 1

Details of Emergency Contact 2

Passwords and Photos

The people that you have put down as your emergency contacts are also noted as authorised to pick up your child from the setting, we will require a photo of them to keep on file. These people as well as any other person that may have to pick up in an emergency that you haven’t noted as authorised, will have to present us with a password of your choice that you have notified us of previously and we will wish to see a form of photo I.D. No child will be able to leave the premises with anyone that is not on the authorised list, or does not know the correct password.

Please create a password which will be used to authorise an alternative person to collect your child.

Additional Information

Any special requests including religion, food, health, allergies, or other matters that we should be made aware of or monitor while your child is in our care.

Schedule

Pick an approximate date you'd like your child to start at the Nursery

Please use the checkboxes below to indicate the days and timings you require.

Full Days (7.30 am - 5.30 pm)

Mornings (7.30 am - 1.00 pm)

Afternoons (1.00 pm - 5.30 pm)

School Day (9.00 am - 3.00 pm)

Ad Hoc Hours (please state times in box) These cannot be guaranteed.

Injections / Immunisation:

Please confirm your child has had the following immunisations (Tick as appropriate)