Registration Form
Child's details
Name:
*
First Name
Last Name
Date of Birth:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
School attended:
Please Select
Crudwell
Oaksey
Minety
Other
Address
*
House name/number
Address Line 2
Town
County
Postcode
Contact 1
Name
*
First Name
Last Name
Relationship to child:
*
Please Select
Parent
Grandparent
Family Friend
Other
Address same as child?
*
Yes
No
Address
House name/number
Address Line 2
Town
County
Postcode
Email:
*
example@example.com
Mobile Number:
*
Job title and Company:
*
Work Contact:
Contact 2
Name
*
First Name
Last Name
Relationship to child:
*
Please Select
Parent
Grandparent
Family Friend
Other
Address same as child?
*
Yes
No
Address
House name/number
Address Line 2
Town
County
Postcode
Mobile Number:
*
Job title and Company:
*
Work Contact:
Contact 3
Name
*
First Name
Last Name
Relationship to child:
*
Please Select
Parent
Grandparent
Family friend
Other
Address same as child?
*
Yes
No
Address
House name/number
Address Line 2
Town
County
Postcode
Mobile Number:
*
Job title and Company:
*
Work Contact:
Medical Information
Name of Doctor:
*
Doctors Practice:
Address
*
House name/number
Address Line 2
Town
County
Postcode
Allergies?
*
Do you consider your child to have a disability? If yes, please provide details.
*
Yes
No
Please provide details below:
Please use the space below to record any information that you may feel is important with regard to your child attending Breakfast and After School Club.
The use of photographs is widely used in play and educational settings for recording, sharing and displaying activities that your children have undertaken. At Oakwell Childcare we take child protection very seriously and we would never publish an image of your child without your consent. As the parent or carer of the child named above, I give permission for images of my child to be used for the following purposes (please tick which ones you are happy for us to do):
*
Facebook page (Oakwell Childcare)
Scrapbooks (only available to the children and parents at school)
Posters to advertise holiday club
None of the above
Photographs
*
I understand that personal details or names of any child in a photograph will never be given in such a way that would allow them to be individually identified.
I understand that this image will NOT be used for anything which may be viewed as negative in tone or that may cause offence, embarrassment or distress for the child or their parent or carer.
Outings and sunscreen
*
Occasionally we may go out and about to the park or other local public areas. If you have any questions or concerns about such visits please contact the club manager/supervisor. Please tick if your happy for your child to visit the local park after informing you a minimum of 12 hours before.
We have a duty of care to protect your child from sunburn and skin damage. Please provide a suitable hat. With your consent we will also help your child apply sunscreen when necessary. Sunscreen needs to be provided by parents. Please tick if you are happy for us to help apply sunscreen
Submit
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