Little Blossoms Preschool / Kids Club Registration Form

Please fill out the form below to complete your booking. You will be contacted to confirm is a space is available.

We accept children from age 2 and they can start as soon as they reach this age. If this is part way through the year and you wish to reserve your space please fill this form out.

If you are booking for Kids Club which includes drop off or pickup from Ballyclare Nursery. Please fill this form out and I will be intouch to chat over options.

Child's Name

Child's Birthday

Child's Gender

Child's Address

Please provide a copy of Birth Certificate (we may still need to see original)

Browse Files

We do require a minimum of two days booking, from experience we find children who attend single days struggle to settle. (If you really can't do two days please get in touch and I can chat with you)

Which days you book is entirely down to your situation we understand the suggestion below might not suit everyone. We will work with your preference.

Our recommendation for two days bookings is

Monday and Wednesday

or

Tuesday and Thursday

For three days adding a Friday as a third is a good option.

If you book 4/5 days, it doesn’t matter which days you book. Again we will work with families on what best suits them.

Please Select your Preferred Session.

If you are happy with any day please state how many days you would like

If we cannot offer you a morning space would you be intrested in a 11.15am -1.10pm space running Monday, Tuesday and Wednesday.

Please select school year you are booking for

I would like to book Kids Club which includes drop off or pick up from Ballyclare Nursery (leave Blank if you are just booking Preschool)

Please select Religion (we have to ask this for funders and to ensure equity of provision).

Other

Does the child have any allergies? If yes, please list them below:

Does the child have any current medical conditions? If yes, please list them below

Does the child takes any medication needed during session? If yes, please list them below and explain its purpose:

Are there any other practitioners involved with your child e.g. Social worker, paediatrician, speech therapist physiotherapist etc. Please list names below, with their contact number. This will help us best support your child.

Please add details here or write none

Do you have any concerns with development or is your child on a waiting list to be seen by other professionals/ practitioners? This is to ensure we can put in place support for your child. Please list or write none.

I give permission for Little Blossoms to contact other practitioners only if needed, to seek advice when supporting my child.

Stage of Toilet training

Parent / Carers Name

Relationship to child:

Parent / Carer Address

PostCode

Parents / Carers Email

Parents / Carers Contact Number

Parent / Carer Name (2)

Relationship to child:

Parents/ Carers Address (2)

Postcode

Parents / Carers Email (2)

Parents/Carers phone number (2)

Please list anyone else who has permission to collect and as an emergency contact. Please provide phone number. At least three names should be available including two listed above. (Must be over 18).

Current Sessions cost £15 each day

An annual £20 registration/booking fee is due with the application. This can be paid via bank transfer.

UPDATE: PLEASE DO NOT SEND THIS WITH FORM UNTIL SPACE HAS BEEN CONFIRMED AS WE ARE NEARLY FULL SOME DAYS. ONCE CONFIRMED THEN YOU WILL BE REQUIRED TO SEND THIS.

Please note Session fees are subject to change, you will be informed asap if any changes to fees.

Fees are due on or before the first school day of each month. If the fees are not paid by the last day of the month then your space will freeze and may be offered to another child.

Registration fee and first month’s fee is non-refundable and must be paid before starting September (or first month start if after September).

If for any reason you wish to withdraw your space please give us a months’ notice.

Payment is by Bank Transfer

Bank Details are

Name : Ballyclare Family Focus

Sort :950679

Account : 80144088

Ref : LB/childsname

We sometimes take pictures of children at our setting for records, updates and use on social media. No names will be used on social media. Only setting camera / device will be used.

Please choose your option for photos

I the parent/guardian of this child give authority to the staff of Little Blossoms Preschool to apply judgment in regards to medical assistance in the event of an accident, injury, or illness if the emergency contact person cannot be reached. I authorise first aid, medical/surgical diagnosis, and treatment which they may deem necessary. I release the organisers, staff, or managers of this setting for any responsibility in case of accident, illness, or injury during my child's enrolment.

I agree to pay fees in advance (before each month) and understand my place will be passed on in the event of non-payment, (end of the month unless agreed otherwise). If I keep my child off I agree to pay for the days, I had booked.

I agree to give permission for staff to take care of toileting needs with my Child.

I confirm that all information given in this form is true, complete, and accurate.

Please sign electronically below. Thanks

Signature

How did you find us?

Little Blossoms Preschool / Kids Club Registration Form

Please provide two contacts details.

Fees

Payment is by Bank Transfer

Permissions and Agreements