Temporary Childcare Service Form
Please choose the childcare services you need
*
Temporary Childcare- Full Day 07:30- 18:30
Temporary Childcare- AM Half Day 07:30- 12:30
Temporary Childcare- PM Half Day 13:30- 18:30
Child Information
Full Name
*
Gender
*
Please Select
Male
Female
N/A
Date of Birth
*
/
Day
/
Month
Year
Child age and room when joining
*
Please Select
Daffodil (0 to 2)
Hibiscus (2 to 3)
Sunflower (3 to 5)
Parent/Guardian Information
First Name
*
Last Name
*
Your Email Address
*
Your Mobile Phone
*
Address
*
Your relationship with the child
*
Please Select
Mother
Father
Co-parent
Aunt
Uncle
Grandparent
Family Friend
Foster Carer
Social Worker
Sister
Brother
Guardian
Other
Attending Sessions
Monday
*
Morning
Afternoon
Full Day
None
Tuesday
*
Morning
Afternoon
Full Day
None
Wednesday
*
Morning
Afternoon
Full Day
None
Thursday
*
Morning
Afternoon
Full Day
None
Friday
*
Morning
Afternoon
Full Day
None
When would you like to start attending our nursery?
*
/
Day
/
Month
Year
Desired last day of attendance: (If you know it)
/
Day
/
Month
Year
Any Allergy or Special Dietary
Anything else do you want to let us know? e.g. interests, preferences, milk, sleep time, comfort toy, special needs...
Permissions
Submit
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