NURSERY REGISTRATION FORM

  • Nursery Registration Form

  • GENDER OF CHILD*
  • Intended Start Date at Rossall Nursery*
     - -
  • Does your child attend any other Nursery setting?*
  • Do we have permission to contact the other Nursery setting as part of our baseline assessment?

  • PARENT(S)/GUARDIAN(S) DETAILS

  • PARENT/GUARDIAN 1

  • Date of birth
     - -
  •  -
  •  -

  •
  • DOES THE CHILD LIVE WITH PARENT/GUARDIAN 1?*
  • DOES PARENT/GUARDIAN 1 HAVE PARENT RESPONSIBILITY OF CHILD?*
  • IS PARENT/GUARDIAN 1 AUTHORISED TO PICK UP THE CHILD FROM NURSERY?*
  • IS PARENT/GUARDIAN 1 THE BILL PAYER?*

  • PARENT/GUARDIAN 2

    If the student is no longer in contact with biological parent 2, please provide an additional contact.
  • Date of birth
     - -
  •  -
  •  -

  •
  • DOES THE CHILD LIVE WITH PARENT/GUARDIAN 2?*
  • DOES PARENT/GUARDIAN 2 HAVE PARENT RESPONSIBILITY OF CHILD?*
  • IS PARENT/GUARDIAN 2 AUTHORISED TO PICK UP THE CHILD FROM NURSERY?*
  • IS PARENT/GUARDIAN 2 THE BILL PAYER?*

  • CHILD'S MEDICAL HISTORY

  • DOES YOUR CHILD TAKE ANY REGULAR MEDICATION?*
  • DOES YOUR CHILD SUFFER FROM A MEDICAL CONDITION? (E.G. EPILEPSY, ASTHMA, DIABETES ETC.)*
  • DOES YOUR CHILD HAVE ANY SPECIAL EDUCATIONAL NEEDS OR DISABILITIES?*
  • DOES YOUR CHILD HAVE ANY ALLERGIES?*
  • WHO WOULD YOU LIKE TO RECEIVE COMMUNICATION FROM THE SCHOOL - PLEASE TICK ALL THAT APPLY:*
  • HAVE YOU VISITED ROSSALL BEFORE?*

  • SESSIONS & AMENDMENTS

  •  

    Dates of intended start in Nursery:

    Please complete the 'Sessions' section below, detailing which sessions you would like your child to attend. Sessions selected are not guaranteed, and are subject to availability until confirmed in the Offer Letter. 

    We have a minimum of three sessions per week.

     

  • Rows
  • PLEASE SELECT YOUR PREFERRED PAYMENT METHOD FOR YOUR MONTHLY FEES:*

  • EMERGENCY CONTACT DETAILS

  • EMERGENCY CONTACT 1 DETAILS

  •  -
  •  -

  •
  • IS EMERGENCY CONTACT 1 AUTHORISED TO PICK UP THE CHILD FROM NURSERY?*

  • EMERGENCY CONTACT 2 DETAILS

  •  -
  •  -

  •
  • IS EMERGENCY CONTACT 2 AUTHORISED TO PICK UP THE CHILD FROM NURSERY?*

  • PERMISSIONS

  • Rows

  • CONSENT

  • Rows

  • DOCUMENT UPLOAD

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  • DECLARATION

  • I/ We confirm that the information supplied is complete and true to the best of my/our knowledge. I/We understand that submission of this form does not guarantee a place for my/ our child or the sessions selected above.


    I/ We acknowledge that a legally binding contract for nursery and childcare services for my/our child will not be formed until the Nursery has received my/our completed Acceptance Form accepting the offer of place as specified in an Offer Letter.

  • REGISTRATION FEE

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      Nursery Registration Fee
      £50.00
        
      Total
      £0.00
      Credit Card Details
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