Hemingbrough Pre-School Admissions Form

Pre-School Admissions Form

This admissions form takes approximately 10–15 minutes to complete. Please ensure you complete all fields marked with a * before submitting your form. We recommend having your child’s personal details, emergency contact information and relevant medical information available before you begin.Thank you for taking the time to complete our admissions form. If you have any questions, please contact us and we will be happy to help.
Child's full name

First NameLast Name
Child's preferred name / name they are known as
Child's date of birth

MonthDayYear
Date
Child's gender
Language spoken at home
Previous nursery or pre-school, if any
Are there any religious, cultural, or family customs we should know about to support your child?
Parent/Carer 1 Details
Parent/Carer 1 full name

First NameLast Name
Parent/carer phone number
Enter a UK landline or mobile number.
Parent/Carer 1 email address
example@example.com
Home Address

Address line 1

Address line 2
Town/CityCountyPostcode
Parent/Carer 2 Details
Parent/Carer 2 full name
Second parent/carer phone number
Enter a UK landline or mobile number.
Parent/Carer 2 email address
example@example.com
Who has parental responsibility for your child?
Who does your child live with?
Preferred start date

DayMonthYear
Date
Which days or sessions would you like?

Other
Will your child use funded childcare hours?
If you have a childcare funding code, please enter it here
Emergency contact 1 full name

First NameLast Name
Emergency Contact Relationship
Relationship to child
Emergency Contact Phone Number
Enter a UK landline or mobile number.
Emergency contact 2 full name

First NameLast Name
Emergency Contact 2 Relationship
Emergency Contact 2 Phone Number
Enter a UK landline or mobile number.
Emergency contact 3 full name

First NameLast Name
Emergency Contact 3 Relationship
Emergency Contact 3 Phone Number
Enter a UK landline or mobile number.
Emergency contact 4 full name

First NameLast Name
Emergency Contact 4 Relationship
Emergency Contact 4 Phone Number
Enter a UK landline or mobile number.
People authorised to collect your child
Authorised collector 1 full name

First NameLast Name
Authorised collector 1 relationship to child
Authorised collector 1 phone number
Enter a UK landline or mobile number.
Authorised collector 2 full name

First NameLast Name
Authorised collector 2 relationship to child
Authorised collector 2 phone number
Enter a UK landline or mobile number.
Authorised collector 3 full name

First NameLast Name
Authorised collector 3 relationship to child
Authorised collector 3 phone number
Enter a UK landline or mobile number.
Collection Word - Choose a word that can be shared with an authorised adult if they need to collect your child unexpectedly. We may ask for this word to confirm their identity before releasing your child.
Is there anyone who must not collect your child or have contact with them?
If yes, please give details
Medical and health information
Does your child have any allergies? If none, please write none.
Does your child have any dietary requirements or restrictions? If none, please write none.
Does your child have any medical conditions? If none, please write none.
Are your child's routine vaccinations/immunisations up to date?
Will your child need any medication while at pre-school?
If yes, please give details, including the medication name, dose, and how it is given.
Does your child have asthma, an inhaler, eczema cream, allergy medication, or a medical care plan?
If yes, please give details
Does your child have any ongoing hospital, consultant, paediatrician, or specialist health support?
Health visitor phone number
Enter a UK landline or mobile number.
If yes, please give details
Health visitor name
Doctor/GP surgery name
Doctor/GP surgery phone number
Enter a UK landline or mobile number.
Development and additional needs
Do you have any concerns about your child's development? If none, please write none.
Does your child have any additional needs, SEND, disability, diagnosis, or support plan?
If yes, please give details
Are any professionals involved with your child's development or learning?
If yes, please give details
Is there anything your child finds difficult, upsetting, or overwhelming that we should know about?
What helps your child feel settled, safe, and comforted?
Safeguarding and family information
Are there any court orders or legal arrangements we need to be aware of for your child?
If yes, please share any details you feel comfortable providing. The setting may request a copy where relevant.
Are there any professionals currently supporting your child or family?
If yes, please share any details you feel comfortable providing.
Is your child currently, or have they previously been, supported by safeguarding or social care services?
If yes, please share any details you feel comfortable providing.
Is there anything else about your child or family circumstances that would help us keep them safe and support them well?
Permissions and consents
First aid treatment
Nappy changing
Applying sun cream
Local walks
Walks to local primary school for transition visits and other events
Photographs on website - no faces visible
Photographs on Facebook - no faces visible
Photographs in learning journals
I give permission for the pre-school to share relevant information with appropriate professionals, such as health visitors, schools, SEND services, safeguarding agencies, and other support services, where this is needed to support my child or keep them safe.
I give permission for the pre-school to contact appropriate health services for advice in an urgent situation if parents/carers cannot be reached straight away.
Parent/Carer signature
Parent/Carer printed name
Date signed

DayMonthYear
Date
Should be Empty:

Pre-School Admissions Form

Parent/Carer 1 Details

Parent/Carer 2 Details

People authorised to collect your child

Medical and health information

Development and additional needs

Safeguarding and family information

Permissions and consents