T.A.S.C. Registration Form
T.A.S.C. After School Care is committed to supporting children and ensuring their wellbeing at all times. The following information is required to ensure that we meet the individual needs of the children within our care. Although the information will be reviewed on a 6-monthly basis, if any details change between reviews, please let us know immediately. IMPORTANT NOTE: The information requested is required through legislation and regulation and we thank you for your understanding. Please be assured that this information is stored in a locked filing system and will be treated confidentially.
CHILD'S INFORMATION
DATE STARTED
Child's Full Name
DOB
Nationality
Religion
Ethnicity
First Language
Any Additional Languages
Please state any religious/cultural requirements
Please state any dietary requirements
Is your child allergic to any of the following? (Please tick any/all which apply)
Celery
Cereals containing gluten
Crustaceans
Eggs
Fish
Lupin
Milk
Molluscs
Mustard
Nuts
Peanuts
Sesame seeds
Soya
Sulphur dioxide (sometimes known as sulphites)
NONE
Does your child have any other allergies?
Yes
No
Does your child have a recognised disability?
Yes
No
If yes, please state what this is.
Does your child have any medical conditions?
Yes
No
If yes, please state what this is/these are.
Doctor's information
Doctor's name
Doctor's telephone number
Doctor's address
School information
School & contact telephone
Primary class & teacher’s name
Named person
Child's Residence
Child’s main residence address
Any additional residence address
Main Contact - Parent/Carer
Parent/carer name
Parent/carer relationship to child
Mobile telephone number
Home telephone number
Work place and telephone number
Email
example@example.com
Do you have any disability /communication requirements we should be aware of?
Additional Emergency Contact
Full Name
First Name
Last Name
Relationship to child
Telephone number
Acknowledgement of Policies and Procedures
By signing this registration form I have access to and I am aware of the policies and procedures in operation within T.A.S.C., including The Child Protection, Fee Policy and Covid-19 Responsibility Policy
Collection Information
Please state the name and relationship of any individuals additional, to the main and secondary contact persons, who may collect your child.
Name
Relationship to child
Name
Relationship to child
Is there anyone who is not allowed to collect or have contact with your child?
Yes
No
If Yes Please State Full Name
Relationship to child
If Yes Please State Full Name
Relationship to child
Main carer’s name sign or print
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: