Enrolment for confirmed places

Please only complete this form once your child has been offered a place.

Please complete all fields marked (*)

Your first name *

Your last name *

Your email *

Child's first name

Child's surname

Known first name

Child's date of birth

Address

Nationality

Religion

Ethnicity

First Language

Language/languages spoken at home

Will your child need support learning English?

First parent contact: Full name

First contact: Relationship to child

Does this person have parental responsibility?

Mobile phone number

Work number (including ext/dept.) or home phone number

First parent date of birth

First parent National Insurance number

E mail address

Second parent contact: Full name

Second parent contact: Relationship to child

Does this person have parental responsibility?

Mobile phone number

Work number (including ext/dept.) or home phone number

Second parent date of birth

Second parent National Insurance number

E mail address

Third emergency contact: Full name

Third emergency contact: Relationship to child

Mobile number

Work number (including ext/dept.) or home phone number

Government funding code (if using)

Name of parent claiming funding code

My child may go on an accompanied visit with staff out of school

Photographs of my child's everyday activities can be used for internal display

Photographs of my child's everyday activities can be used on the setting's website

Photographs of my child's everyday activities can be used in online newsletters to parents

Photographs of my child's everyday activities can be used for newspapers/publications

I agree to staff applying sun screen to my child when appropriate

My child CAN eat the following:

Red meat

White meat

Fish

Dairy (inc milk/cheese/yoghurt)

Eggs

Foods NOT to be given

This is due to:

Doctors name, medical practice name and address

Do you give p[ermission for the setting to call a doctor in an emergency

Do you give permission for the setting to administer first aid in an emergency?

Please provide details of any medical conditions that we should be aware of and any emergency actions that should be taken

In line with GDPR, I understand that my child's information may be held securely on OCC and Slade Nursery databases. Please tick box.

I am happy to be contacted by e mail

Please sign and date here: