• CHILD REGISTRATION FORM

  • Please ensure that you read this form carefully and answer all questions. We have a responsibility under the Child Care Act 1991 (Early Years Services) Regulations 2016 to collect specific information relating to your child. Also, the more information we can gather the better quality a service we can provide. Please also ensure you have fully read and signed the COVID-19 Parent & Child Forms that accompany this registration form ahead of your agreed start date. Thank You!

  • 1. BOOKING INFORMATION

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  • 2. CHILD INFORMATION

  • Signature boxes MUST be signed by a Parent/Guardian and witnessed by the Service Manager or Designated Person in Charge.

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  • (please notify management if address changes)

  • 3. MEDICAL INFORMATION

  • Who may be contacted in an EMERGENCY if parents/guardians are uncontactable or unavailable?

  • CHILD’S GP/ FAMILY DOCTOR

  • NOTE: Medical Care Plans may be required. Parents/Guardians will be asked to collaborate in the forming of care plans.

    In the case where your child has an immunodeficiency, you may be asked to complete a Compromised Immunity Form with us as part of a COVID-19 Risk Assessment and help us form an individual care plan for your child ahead of attending our care setting.

  • If YES, please complete the following form

  • To be filed in the child's records and be available to staff via ALLERGY ALERT ID SIGN & INFO in an appropriate area in the relevant care space. Induction on storage and administration of any allergy-related medicines (inc. Epipen) to be provided to all staff ahead of the child's commencement in the care setting.

  • PRESCRIBED MEDICATION

    Parents/Guardians must sign and complete a Medication form before Prescribed Medication is administered. Prescribed Medication must clearly state child's full name, dosage, route of administration, date and expiry date. We can only accept medicine that has the original pharmacy label and is written in the English language.

    AGREEMENT FOR MEDICAL TREATMENT

  • I hereby give consent to my child receiving medical treatment in the case where a doctor considers it required as an emergency and I cannot be contacted following reasonable attempts to do so prior to such treatment being administered. In the event of an emergency an ambulance will be called.

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  • AGREEMENT FOR ANTI FEBRILE MEDICATION

    The service will only administer 'Calpol' (paracetamol) or Nurofen (Ibruprofen) if a child becomes unwell and has high temperature of 38°C or over that does not begin to decrease under close supervision within a period not exceeding 10 minutes. If a child has a high temperature the parent/guardian will be contacted before staff administer the temperature reducing medication and they will be asked to arrange to collect the child promptly. In the case where the service is unable to make contact with the parent/guardian within the 10 minutes of temperature supervision checks, Anti-febrile medication (Example, Calpol, 2 months +) will be administered by a designated person to the child where the below signature is provided.

  • I hereby* to * to receive anti-febrile medication in the event of a high temperature.

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  • 4. IMMUNISATION

  • (Please note Vaccination requirements are subject to change depending on your child's Date of Birth)

    Immunisation is a simple, safe and effective way of protecting babies and children against certain diseases. The risks from having these diseases are far greater than the risk of any minor side effects from immunisation. When your child is given a vaccine, their body responds by making antibodies, the same as if they caught the disease but without getting sick. The antibodies they make destroy the vaccine content and stay in their body to help them fight the actual disease should they ever get it.

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  • We ask that Parents/Guardians supply a copy of all Immunisations/Vaccinations the child has received to date

  • I confirm that my child has been vaccinated on dates as above.

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  • OR

    I confirm that my child has been vaccinated but I cannot currently access details of dates (Please request these from your child's GP)

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  • If your child has not been vaccinated we may require you to sign a disclaimer form. Please make an appointment to speak with management if you have chosen not to vaccinate your child.

  • SUN POLICY

    We ask Parents/Guardians to provide the service witha ‘sunny day bag’ for their child with sun hats,sunglasses etc. All childrenwill be required to wear a sun hat when playing outsidein the sun. The service will encourage all childrento wear clothes thatprovide good sun protection e.g. sun hats, sunglasses.The service will also encourage children to coververy exposed areas ofthe skin, such as shoulders.

    We ask Parent(s)/Guardians to bring in a labelled bottle of Travel-size unopened sun-cream of at least40 SPF. Staff will apply thesun-cream to children before they go outdoors. Parent/Guardianswill be informed if/when a new supply is required,and this isexpected to be replaced promptly. In the case wherean individual sun-cream has not been provided, staffwill supply the childwith an in-house children’s hypoallergenic sun-cream(at least 40 SPF)

  • I give permission for sun-cream to be applied to my child * from the labeled sun cream supplied. The sun cream will be applied in the correct way all over the exposed parts of the body, including the face, and in the correct amount. I will bring in an unopened and labelled bottle of sun-cream of at least 40 SPF.

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  • 5. PERMISSION

  • I give permission for my child:

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  • CHILD PROTECTION

    We have a moral and legal obligation to ensure that all children in our care are protected, and their health and welfare are safeguarded.

    Our staff are mandated to report any concerns.

    All staff in the service are vetted through the Garda vetting unit and have the correct qualifications to work with children. We act to protect children from harm, which may arise. It is our duty in this case to question the cause of any behaviour, bumps, bruises or unusual markings. Our main concern in the service is to safeguard and protect the welfare of children. We have a responsibility to identify, report and record any suspicions of child abuse to Tusla, the Child and family Agency. We have a responsibility to respond to all child protection concerns.

  • 6. AUTHORISED COLLECTION

  • 6. AUTHORISED COLLECTION

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  • Separated and Divorced Parents

    Married parents are automatically joint guardians of their children. Neither separation nor divorce changes this. By law, an unmarried mother is the automatic guardian of a child born outside of marriage. In some circumstances, unmarried fathers have automatic access. The service should be informed about access rights. Unmarried fathers will automatically become guardians of their children if they meet a cohabitation requirement. An unmarried father who cohabits for 12 months with the child's mother, including 3 months following a child's birth, will automatically become the child's guardian. This provision is not retrospective, so guardianship will only be acquired automatically where the parents live together for at least 12 months (applies to children born after 18 January 2016

    We cannot refuse either parent to collect their child unless a court order is in place.

    We ask that parents/guardians give us information on any person that does not have legal access to the child.

    Where custody of a child is granted to one parent, we would ask you to clarify the circumstances with us. This information will remain confidential and will only be made known to the relevant staff. If there is any legal documents i.e. custody order, barring order in place, we would ask you to provide us with a copy to keep on your file. This will be returned to you whenever care for your child ceases.

  • 7. ATTACHMENT CHECKLIST

  • Please ensure the following are attached

    • Copy of immunisation record (Immunisation Passport or GP Print-out)
    • Signed COVID-19 Child & Parent Forms (All parents/guardians must confirm receipt of service's COVID Policy Response Plan
    • Photo of child, Parent/Guardian and other collectors (where applicable)

    And if applicable:

    • Medical Emergency Care Plan (such as Allergy)
    • Other Care Plans (Compromised Immunity or AdditionalNeeds)
    • Any relevant Doctor / Consultant Notes
  • 8. ‘ALL ABOUT ME’ (OPTIONAL)

  • We believe it is important to know as much as we can about a child before they start our service. Completion of the following section of this registration form is optional for parents and guardians, but we believe it helps us to get to know the child and helps settle a child into the service if we know things about them.

  • Is there any other relevant information you would like us to know about your child?

  • 9. DATA CONSENT

  • Data Privacy - Consent for Collection and Usage of your personal data

    Please ensure that all parents or guardians whose information has been supplied in this form read and complete the following.

    I have read the Service's Privacy Notice, and I understand the reasons for requesting the personal information sought about myself and my child in this Registration form.

    I consent to the collection and processing of the data given, for these sole purposes, by [Service name]

    I understand that I can request a copy of this information, and revise or withdraw my consent by contacting the service at any time.

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