Course Registration Form Nursery

Section 2. Family Information

Please Enter Details Below
Parent/Carer details: Please indicate which parent is the Primary Guardian by ticking the boxes below. (Please use additional sheets for any court orders. If child in care please provide Carer information.) *

Parent 1 Parent 2 Both
Parent 1 Full Name: *

First Name Last Name
Relationship to Child: *
Home Address: *

Street Address

Street Address Line 2

City

Postal / Zip Code
Home Telephone No:

Area Code Phone Number
Phone Number *
Please enter a valid phone number.
Work Telephone No:

Area Code Phone Number
Email *
example@example.com
Parent 2 Full Name:

First Name Last Name
Relationship to Child:
Home Address:

Street Address

Street Address Line 2

City

Postal / Zip Code
Home Telephone No:

Area Code Phone Number
Mobile Phone Number:
Please enter a valid UK Mobile number.
Work Telephone No:

Area Code Phone Number
Email
example@example.com
Details of Siblings In Other Schools:
Details of Siblings In This School:

Section 3. Child's Previous Schooling (if applicable)

Please Enter Details Below
Last School Attended:
Address of Last School:

Street Address

Street Address Line 2

City

Postal / Zip Code
Start Date:

Month Day Year
Date
Leaving Date:

Month Day Year
Date
Other Schools Attended:
Reason for Leaving:

Section 4. Emergency Information

Please fill in details below of emergency contacts in addition to Primary Guardian(s). If we have difficulty contacting you, we will contact the people provided below. Place them in the order to be contacted in an emergency. E.g. Aunty, Uncle, Family Friend etc.
Emergency Contact 1: *

First Name Last Name
Telephone Number: *
Please enter a valid phone number.
Relationship to Child: *
Authorised to Collect?: *

Yes No
Emergency Contact 2: *

First Name Last Name
Telephone Number: *
Please enter a valid phone number.
Relationship to Child: *
Authorised to Collect?: *

Yes No

Section 6. Dietary Requirements

Please Enter Details Below
Please Select the Diet Which Best Reflects Your Child's Needs: *

No special dietary requirements Non-Halal Halal Vegetarian
Does Your Child Have any Food Allergies? (If there are any food allergies, you are required to fill in a special diet form which will be supplied to you. The catering company requires a medical note from your doctor which allows them to cater to the child's needs.) *
Please separate multiple by comma

Section 7. Additional Funding

Parents are strongly advised to apply for FREE SCHOOL MEALS and PUPIL PREMIUM across all Year Groups. If you are in receipt of one of the following benefits, the school may be eligible for additional funding to support your child.
Please Tick Benefit/s Received: *

Income Support Income Based Job Seeker's Allowance Child Tax Credit where the family's annual income is not more than £16190 Guaranteed Pension Credit Support Under Part Six of the Immigration and Asylum Act 1999 No Benefit Recieved
Name of Parent Receiving Qualifying Benefit: *

First Name Last Name
Parental declaration: I declare that the information given is correct to the best of my knowledge and I AGREE to inform Children’s Services of any change in circumstances and I will produce proof of my income as required. The information I have given on the form is true and complete. I accept that the Authority will retain my details for ongoing eligibility checking of my entitlement to Free School Meals and that the Authority may: use this information in the detection and prevention of fraud, share this information with other departments who deal with public funds, or write to the Home Office to check the information I have given. I will inform the Authority of any changes to my circumstances which may affect my entitlement to claim Free School Meals and I will inform my child’s school at once if my FSM entitlement ends and accept that I will be responsible for any charges incurred during this time from which my benefit entitlement ceases. I give the Children’s Services Admissions & Awards Team permissions to verify my claim for Free School Meals or Pupil Premium from records with other Council Departments or the DFE database to confirm.
Parents Signature *

Clear
Date *

Day Month Year
*

A copy of my most recent HMRC statement of benefits has been provided to the school.
*

I give the School permission to process my application for FSM on my behalf.

Section 8. Consent

Please Tick To Consent.
Attendance: *

In the event of my child’s absence, I will inform the school office before 9:30am
Visits: (We will contact you prior to a visit and the children will be supervised at all times.) *

I give permission for my child to be taken on school visits in the local area. (Wanstead flats, Wanstead park, Wanstead High Street, School allotment, Local library, Venue for school productions – the local church and Wanstead High School etc.) I DO NOT give permission for my child to be take on school visits in the local area.
Digital and Media Permission *

I give permission for my child to be involved in activities in school using digital media, videos, photographs and podcast (for examples: school website/displays/documents/video conferencing/local and national newspaper) I DO NOT give permission for my child to be involved in activities in school using digital media, videos, photographs, and podcast.
Digital and Media Permission *

I understand that I may withdraw this consent at any time by writing to the office
Behaviour *

I agree to support the policies of the school and to encourage my child to follow the school rules and to behave with consideration to other people

Section 9. Declaration

Please Sign Below
I have read and understood the content of this form.
The information given on this form is correct.
I understand that I MUST inform the school should the details given change.
Signed: *

Clear
Date: *

Day Month Year
Date
Print Name: *

First Name Last Name
Relationship to Child: *
Data Protection Act 1998 – The School is collecting this data in order to meet its statutory responsibilities for the provision of education to children in accordance with the requirements of the Education Act 1996 and The School Standards and Framework Act 1998. Some of this data will be shared with the Local Authority and may be shared with other agencies that are involved in the health and welfare of school children.
PROOF OF IDENTITY AND ADDRESS

We are required to undertake satisfactory checks to ensure the Identity and Address of Children enrolled at Aldersbrook Primary School.
Please supply the following to complete registration;

Proof of Child’s Date of Birth, provide one:
- Birth Certificate
- Passport
Proof of Residency, provide two:
- Rent book/tenancy agreement
- Council Tax Statement/book
- Mortgage Statement
- Bank/Building Society Statement
- Utility bills Gas/Electricity/Telephone
Please use the File Upload Below to Upload a PDF/Copy of documents.
File Upload *

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Aldersbrook Primary School

Section 1. Student Details

Section 2. Family Information

Section 3. Child's Previous Schooling (if applicable)

Section 4. Emergency Information

Section 5. Medical/Health/SEN Details

Section 6. Dietary Requirements

Section 7. Additional Funding

Section 8. Consent

Section 9. Declaration

PROOF OF IDENTITY AND ADDRESS