Apple Daycare Ltd

Child Registration Form

Parent First Name

Parent Last Name

Primary Parent Email

Parent Contact Number

Preferred Start Date @ Nursery

Parent/Carer 1: National Insurance Number

Parent/Carer 2: National Insurance Number

Upload Child's Face Picture

Child's First Name

Child's Last Name

Child's Date of Birth

Which best describes your Child's gender?

Which setting do you want your Child to attend?

Allergy Information

Please let us know what allergy(s) your child has and what is/are the reaction(s) we can expect? How would we treat the reaction should it occur at nursery?

Intolerance Information

Please let us know what intolerance(s) your child has and what is/are the reaction(s) we can expect? How would we treat the reaction should it occur at nursery?

Specific Dietary Preferences

Collection Password

The password is for someone who doesn’t usually collect your child or if staff are unfamiliar with a parent e.g. Rosebud

Child's Eye Colour

Child's Hair Colour

Child's Religion

Child's Nationality

Child's First Language

Does your child have Special Needs or Disabilities?

Child's NHS Number

Plus Extra Hours

Contract Type

What school are you employed at and what position do you hold?

Funding

If you are using government funding, which type will you be claiming?

Parent 1: House Name or Number

Parent 1: Street Address Line 2

Parent 1: City

Parent 1: County

Parent 1: Postal Code

Parent 1: Country

Parent 2: First Name

Parent 2: Last Name

Parent 2: Email

Parent 2: Phone Number

Parent 2: House Name or Number.

Please fill these boxes with N/A if address is the same as Parent 1.

Parent 2: Street Address Line 2

Parent 2: City

Parent 2: County

Parent 2: Postal Code

Parent 2: Country

Parental Responsibility

Both Mother and Father have Parental Responsibility

Only Mother has Parental Responsibility

Only Father has Parental Responsibility

Collection from Nursery

Both Mother and Father are allowed to pick up from nursery.

Only Mother allowed to pick up from nursery.

Only Father allowed to pick up from nursery.

Responsibility for Fees

Both Mother and Father have Responsibility for Fees

Only Mother has Responsibility for Fees

Only Father has Responsibility for Fees

Name of Primary Emergency Contact

Primary Emergency Contact Number

Name of Secondary Emergency Contact

Secondary Emergency Contact Number

Name of Non-Household Emergency Contact

This is a Ofsted requirement should we have a safeguarding concern and need someone to check in on your household on behalf of the nursery.

Non-Household Emergency Contact Number

GP Surgery

GP Name

GP Phone Number

Health Visitor Name

Health Visitor Phone Number

Permissions

Permission to attend Nursery Trips:

I would like my child to be taken on routine outings to the shops, schools and pre-schools and local facilities without asking each time.

I give permission for my child to be taken on special trips, for example to the seaside, London attractions etc, however I would like to be advised of all such trips in advance where possible.

Permission to Administer non-prescription medication:

I will advise the nursery, when dropping off my child, if I have already given any medication prior to arrival.

I give permission to my Apple Daycare Manager to administer (Calpol 0-6)I expect Apple Daycare to contact me prior to administering the medication, especially if my child has been in their care for less than 4 hours.

I give permission to my Apple Daycare Manager to administer (Nurofen)I expect Apple Daycare to contact me prior to administering the medication, especially if my child has been in their care for less than 4 hours.

I give permission to my Apple Daycare Manager to administer (Gel/Grannules )I expect Apple Daycare to contact me prior to administering the medication, especially if my child has been in their care for less than 4 hours.

I give permission to my Apple Daycare Manager to administer (Piriton)I expect Apple Daycare to contact me prior to administering the medication, especially if my child has been in their care for less than 4 hours.

I give permission to my Apple Daycare Manager to administer (Cough)I expect Apple Daycare to contact me prior to administering the medication, especially if my child has been in their care for less than 4 hours.

Observational Permissions:

I give permission for Apple Daycare Ltd to carryout and record observations on my child, in order for her to respond to his/her individual needs and plan activities to support his/her development.

I understand that these observations are confidential and will be shared with only myself. However I do give permission for these to be shown to professionals such as Ofsted Inspectors, if requested.

Apple Daycare qualified Staff to administer first Aid & authorise First Aid assistance to my child as and when necessary, or in the event of an emergency to seek medical/hospital assistance in our absence as appropriate.

ADC will not be able to authorise any treatment. We as the child’s next of kin will be contacted by medics in an emergency to give permission.

I give permission for Apple Daycare Ltd to allow my child to sleep in a pram [or lie-flat pushchair ] if they are lying flat.

Photography Permissions:

Whilst your child is in Apple Daycare Ltd’s care we will be taking photographs for a variety of different purposes. We know that some parents are concerned about this and therefore we request that you complete this form, in order that we may comply fully

The Type of Photographs Include (Check to authorise)

Child Development & Profile

ADC Photo Album

Nursery Display Boards & Portfolios

Nursery Promotional Literature

Nursery Website

Student Course Work for Qualification

Photos of Child during Activities to take home

Group Photos to take home

Mobile phone (If a child is distressed at drop off, you may wish the Manager or Duty Manager to take a picture on the Nursery Mobile Phone & send it to you when they have recovered. This photo will be deleted straight away.)

Parent #1: By submitting this form online, I agree to abide by the terms, conditions, policies and procedures of Apple Daycare Ltd which I have read and fully understand. I confirm reading Apple Daycare's T&C's on their website [password Apple123]

Signature field is empty.

Parent #2: By submitting this form online, I agree to abide by the terms, conditions, policies and procedures of Apple Daycare Ltd which I have read and fully understand. I confirm reading Apple Daycare's T&C's on their website [password Apple123]

Signature field is empty.

This Registration Form was completed on:

Thank you for registering your child to our Nursery. We will be in touch soon to confirm a start date and to arrange settle sessions.