PreSchool Admissions Form

  • Birchwood Preschool

    'A Bright Start to a Brighter Future'
    Birchwood Preschool

  • Preschool Admissions Form

  • For further information or any queries please email preschool@birchwoodnursery.herts.sch.uk

  • About your Child

  • Gender*
  • Date of birth*
     - -
  • Previous setting attended*
  • Attended from:*
     - -
  • Attended to:*
     - -

  • Other children in family

  • Date of birth
     - -
  • Add 2nd child
  • Date of birth
     - -
  • Add 3rd child
  • Date of birth
     - -

  • Parents/Carers/Contacts

  • Parent/Carer 1

  • Parental responsibility*
  • Date of birth*
     - -
  • Is there another parent who has parental responsibility?*

  • Parent/Carer 2

  • Parental responsibility*
  • Date of birth*
     - -

  • In the event that we are unable to contact you, please provide in priority order the names of additional local people we can contact in an emergency:

  • Sessions Required

  • Please enter required start date:*
     - -
  • Rows

  • 2 Year Old Funding

    Two year old government funded nursery places are available if you meet certain criteria and are available from the term after the child’s 2nd birthday. Places are taken over 38 weeks per year.

  • I confirm that I am eligible for the 2 year old free education funding.

  •  

    30 Hours Entitlement

    If both parents/single parents are working more than 16 hours at minimum wage (or equivalent) and have an adjusted net income of no more than £100,000 per year. Eligibility is checked via an online application, and you can check your eligibility and apply on the your child is entitled to 30 hours per week for 38 weeks of the year free child care. 

    Parents must apply online at www.childcarechoices.gov.uk to obtain an eligibility code before a 30 hour place can be confirmed. 

  • I confirm that I am eligible for the 30 hour offer and will apply at the earliest date possible. I will provide the 30 hour code to Birchwood Preschool once received and understand that any offer of a 30 hour place is conditional upon this requirement. Failure to comply may result in the offer being withdrawn.

  • Extended Care

    Please specify any additional hours you require above the funded hours you are entitled to. Please note these are subject to availability and are payable monthly in advance.
  • Additional hours

  • Medical Information

  • Does your child have any medical conditions including allergies?*
  • In the event of an emergency and you are unable to contact any of the emergency contacts listed above, I give permission for my child to be accompanied by a member of staff and taken to hospital in an ambulance. If necessary I give permission for my child to be X rayed. *
  • In the event that my child experiences breathing difficulties and medical advice is sought from the emergency services, I give consent for staff to administer the school salbutamol inhaler if advised*
  • In the event that my child experiences an allergic reaction and medical advice is sought from the emergency services, I give consent for staff to administer the school EpiPen if advised*

  • Dietary Needs

  • Does your child have any special dietary needs?*
  • Special dietary needs*

  • Please note that parents of children with a food allergy who will be having a school meal with us must complete our catering contractor’s medical questionnaire BEFORE any school meals will be provided. You will be asked to provide medical evidence.

  • Special Educational Needs & Social Care

  • Does your child have an Education, Health & Care Plan or an Individual Education Plan?*
  • Is your child or a sibling of your child the subject of an inter-agency child protection plan and has been placed on the Child Protection Register?*
  • Is your child looked after, or has previously been looked after?*
  • Is your child adopted or under special guardianship?*
  • Are there any social or medical concerns?*
  • Are there any other professionals involved with your child?*

  • Ethnicity & Culture

    Please tick one box below to indicate the ethnic background of your child
  • White
  • Mixed
  • Asian or Asian British
  • Black or Black British

  • Religion

  • Service Child in Education

  • Has either parent served in the Armed Forces?*
  • Date from*
     - -
  • Date to*
     - -

  • Use of Images

  • While your child is at Birchwood we would like to take photographs or video of them in order to capture their learning and their experiences. These are included on their learning journals which will be available for you to see at Birchwood and electronically. We also sometimes use children’s photographs in displays, literature, staff training, our website and Facebook page and occasionally for the local newspaper. We would like your permission to use photographs or film of your child in this way. 

    To comply with the Data Protection Act 1998, we need your permission before we can photograph or make any recordings of your child. Please answer the questions below, then sign and date the form where indicated.

    I give permission for my child to be photographed and filmed on video for:    

  • My child's learning journal (Tapestry)*
  • Within a group photo in the Nursery/Pre-School*
  • Displays of learning and experiences within the Nursery/Pre-School*
  • In the Nursery/Pre-School's publications produced for promotional purposes*
  • On our website*
  • On our Facebook page*
  • An article in the press*

  • Please note that websites can be viewed throughout the world and not just in the United Kingdom where UK law applies.

    Conditions of use

    • Please contact Birchwood at any time if you wish to withdraw your consent.
    • We will not use the personal details or full names (which means first name and surname) of any child or adult in a photographic image on video, on our website, in our documentation or in any of our other printed publications.
    • We will not include personal e-mail or postal addresses, or telephone or fax numbers on video, on our website, in our documentation or in other printed publications.
    • If we use photographs of individual pupils, we may use the first name of that child in the accompanying text or photo caption within the school or for training purposes, but not in any media publications.
    • Photos used within the school for display may be accompanied by the child’s first name, describing what s/he is doing.
    • We may use group or class photographs or footage with very general labels, such as “making Christmas decorations”.   

  • Additional Information

  • I give consent for nappy/clothing to be changed by members of staff*
  • I give consent for nappy cream to be applied when necessary*
  • I give consent for sun cream to be applied when necessary*
  • I give consent for face paint to be applied as required*
  • I give consent for sensitive skin wipes to be used*
  • I am willing for my child to join outings organised by the Class Teacher / Pre-School staff e.g. a short walk, visit to local shops.*

  • Data Protection: In accordance with General Data Protection Regulation and current Data Protection Act, the school has a duty to protect this information and to keep it up to date. The school is required to share some of the data with the Local Authority and with the DfE.

    Privacy Notice for Parents

    In completing this application form you should refer to our Privacy Notice for Parents. The personal information collected on this form will be processed to manage your application in accordance with this policy.

  • Are you happy for us to share information with your child's next setting?
  • Are you happy for us to receive information from and contact your child's previous setting?
  • Should be Empty: