About Your Child
Name of the parent(s)/carer(s) with whom the child lives:
Emergency contact details (if parents are not available) Emergency contacts must be local.
Person(s) other than parent(s) authorised to collect the child (must be over 16 years of age). Please note that if the authorised person is not the person collecting the child on a daily basis staff will check with you before releasing the child.
Contact details of Health Professionals:
Health and development
ASQ-3 Progress Check
As per the requirements of the Early Years Foundation Stage we will complete a progress check on your child from 36 months onwards. We will ask you to be involved in completing the check and will discuss it with you.
Please sign below to indicate that the information given on this form is accurate and correct, and that you will notify us of any changes as they arise
TO BE FILLED BY MEMBER OF STAFF