Woodentops Registration Form

Woodentops Registration Form
Registration Form
Woodentops charge a fee per hour for those children not yet entitled to funded childcare. Invoices are sent out at the beginning of the month with payment due within 7 days. If payment is not received you are at risk of loosing your child's place at Woodentops.*

I agree to pay the hourly rate.
Securing a place at Woodentops.

To secure a place at Woodentops, there is a registration fee of £25, payable when the registration form is filled in.

Payment should be made by bank transfer to Woodentops Preschool bank.

Starling Bank, Account no- 68475097 Sort code 60-83-71

This will guarrantee a space at Woodentops Preschool, it may not guarrantee the days/ hours you have requested but we will try to accomodate as much as possible.
Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Funded Hours

These are accessible for children who are entitled to 2 year old Funding, three and four year old funding.

Those children pay a voluntary sessional fee - see table below, to cover additional costs that the funded grant does not cover.

Our funded sessions are £6.60 for a morning session (9 am to 12pm), £6.60 for an afternoon session (1pm to 4pm) or £13.20 for an all day session (9am to 3pm). Any additional hours ie 8am to 9am, 12 to 1pm or 3pm to 4pm are charged at the usual hourly rate.

Parents can access upto 24 hours of funded childcare at Woodentops per week, any hours required over the 15 or 24 funded hours are charged at our hourly rate of £8.80
Opt- Out Process

To ensure the smooth operation of Woodentops preschool and continue to make Woodentops a viable business, parents must email with a months notice to inform us they wish to opt out of paying the voluntary sessional amount that their child is booked on.

Parents then must the ensure they supply daily: -
- fruit/vegetable pieces- washed and cut up ready to eat with a savoury biscuit in a named pot- no sweets/ chocolate or nuts please.
- pack of wipes- named
- pack of disposable gloves- named
- water in a named bottle
- nappy sacks- named
- suncream -named
- welly boots named
- waterproof trousers- named.
All these should be in a named bag that the child can carry themselves and must come in and go home daily as we have very little storage space.
Termination of contract

A months notice is required for termination of contract. it must be written, emailed over or messaged over on hte Famly App.

If you remove your child without notice you will be required to pay 4 weeks fees.
Preferred start date*

DayMonthYear
Date
Parents need to book their child's sessions for the whole term. Please note invoices are sent out at the beginning of the month with payment due by 7th of the months invoice. If payment is not received you are at risk of loosing your child's place at Woodentops.

I understand that I am expected to pay the voluntary sessional charge for the sessions my child is booked on.
Fee Reviews

Fees are reviewed in August and December to ensure Woodentops remains viable.

What hours would you like Monday to Thursdays? We're open from 8 am to 4pm Mondays to Thursdays.

	Monday
8am to 4pm
8am to 9am
9 to 12pm
1 to 4pm
9 to 3pm
3pm to 4pm

Type a question

	Tuesday
8am to 4pm
8 to 9am
9 to 12pm
1 to 4pm
9 to 3pm
4 to 4pm

Type a question

	Wednesday
8am to 4pm
8am to 9am
9am to 12pm
1pm to 4pm
9am to 3pm
3pm to 4pm

Type a question

	Thursday
8am to 4pm
8am to 9am
9am to 12pm
1pm to 4pm
9am to 3pm
3pm to 4pm

Signature to agree to pay fees

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Child's Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ethnicity*
Birth Certificate Number*
Gender*

MaleFemale
Who does your child normally live with?*

Both parentsParent 1Parent 2Carers/ Grandparents
2 year old Funding Unique CPEI Number
30 hour Funded Code for 2 year olds and 3 year olds.
An 11 digit number that working parents apply for to entitle them to 30 hours funding. If no code add a zero
Parent 1/ Carer 1 name *

First NameLast Name
Does parent 1/ carer 1 have parental responsibility?*

YesNo
Parent 1 / Carer 1 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1 telephone number*
Parent 1 / Carer 1 National Insurance Number*
Parent/ Carer 1 Date of Birth*

DayMonthYear
Date
Parent 1 email*
example@example.com
Parent 2 / Carer name*

First NameLast Name
Does parent 2/ carer 2 have parental responsibility?*

YesNo
Parent 2 / Carer 2 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 telephone number*
Parent 2/ Carer 2 National Insurance Number*
Parent /Carer 2 Date of Birth*

DayMonthYear
Date
Parent 2 email*
example@example.com
Which Immunisations has you child had? Please tick all that apply to your child.*

6 in one vaccine at 8, 12 and 16 weeks oldRotavirus vaccine at 8 and 12 weeks oldMenB vaccine at 8 and 16 weeks oPneumococcal at 12 weeksHib/MenC at 1 yearMMR at 1 yearPneumococcal at 1 yearMenB at 1 yearFlu vaccine from 2 years old- annuallyMMR at 3 years and 3 months4 in 1 preschool booster
Do you give consent for us to give your child their prescribed medicines as and when instructed by yourselves?*
A medication form will need to be filled in and signed by parents with clear method of administering the medication.
Consents- I agree for my child to :- please tick all that you agree to*

Have First Aid treatmentHave Emergency treatment- 999Have Factor 50 sun cream applied when neededHave Zoono hand sanitiser applied on arrival to WoodentopsUse alcogel if needed.Be given their own prescribed medicines, by your Dr, as long as you have signed to agree that they can be givenHave photos taken to be added to your child's Woodentops JourneyBe added to the Famly App
What medical conditions does your child have? *
Please add how we can manage your child's care at Woodentops. Please type none if they have no medical conditions. Thank you.
What allergies or sensitivities does your child have?*
Please state how we can support your child when at Woodentops. Does he/she use an epipen? Please type none if your child has none. Thank you.
Is your child sensitive or allergic to penicillin?

YesNo
Drs name and Surgery name*

Drs nameSurgery and contact number
Health Visitor*

Health Visitor nameContact number
Do you give us permission to share your child's information with the 0-19 health care team?*
This is to ensure your child gets their 3.25 year old health care check.
Do you give us permission to share your child's information with other agencies such as the Education and Healthcare teams? *
This is to cover the funding forms, school admissions, school that your child is due to attend ETC.
I give Woodentops permission to share information with: - Tick all that you agree too.*

Your childminderyour future/ applied for school so ensuring good transition to school and ensure child's wellbeing and happiness is consistent between settingsother preschool if sharing care/ moving preschoolsCentral Beds SEND team if needed, in order to gain support for our staff and your childHealthcare teamSpeech and language team if neededCentral Beds Funding team in order for us to claim fundingThe 0 -19 team where we do do joint development review
Dentist Name and contact number*
How often does your child visit the dentist?
It should be roughly every 6 months.
Do you have any professionals supporting your family at the moment? If so who are they and why? *
This gives us an idea of how we can support you and your child. If receiving no support just state Not applicable
What kind of diet does your child have?*

No specific dietary requirementPescatarian-FishVegetarianVeganCultural dietNo porkNo beefGluten free dietDairy free
Please expand on your child's dietary needs.
Data Protection As part of the GDPR (25/5/18) we collect yours and your child’s data to be able to provide care for your child. You can request any information we hold about you or your child at any time. Any information about you or your child is stored securely at Woodentops in locked cabinets. We do not share your data with anyone unless we have your specific permissions to do so- for example- schools, speech and language therapists. Please see our GDPR policy statement in the website www.woodentops-potton.com and in the policy folder in the foyer. By signing this form, you are agreeing to the use of yours and your child’s data whilst at Woodentops Preschool. *

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Security Please provide details below of other people aside from yourself/yourselves who have your permission to collect your child on your behalf. Please * each name that is to be used as an emergency contact should we be unable to reach either parent.*
Does your child attend any other childcare setting including Childminders, nursery, preschool or a nanny? If so what's their name and contact details?
Do you give us permission to work in partnership with your child's childminder, nanny, nursery or preschool? This will mean sharing information regarding your child's learning and development. This will be great for supporting your child's learning.*

YesNo
Please add the contact details of your child's other setting including your child's key persons name.*
If no other setting involved state not applicable.
Have you any concerns about your child's development? if so what are they?
Please provide the name, role, organisation and contact details of any professionals (Social Services, Children's Centre, Health Visitor, Home start for example) who are working or have ever worked with your family and child. *
If none please type none. Thank you.
Please add any other relevant information regarding your child
Thank you for completing this form. It will help us to support your child. Signature

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