Registration Form

Registration Form
Please complete a registration form for each child you wish to attend the Nursery.
Child's Name*
Date of Birth*

DayMonthYear
Date
Parent's Names:*
Address*

Street Address

Street Address Line 2

TownCounty

Post Code
Home Tel No:*
Mobile:*
Work Tel No:
Email address:*
example@example.com
Days and times required:
Monday:*

Full Day 7.30 - 6Morning 8-1Afternoon 1-6School Day 9-3Before SchoolAfter SchoolNoneOther
Tuesday:*

Full Day 7.30 - 6Morning 8-1Afternoon 1-6School Day 9-3Before SchoolAfter SchoolNoneOther
Wednesday:*

Full Day 7.30 - 6Morning 8-1Afternoon 1-6School Day 9-3Before SchoolAfter SchoolNoneOther
Thursday:*

Full Day 7.30 - 6Morning 8-1Afternoon 1-6School Day 9-3Before SchoolAfter SchoolNoneOther
Friday:*

Full Day 7.30 - 6Morning 8-1Afternoon 1-6School Day 9-3Before SchoolAfter SchoolNoneOther
Will you be using Government funding towards your child's fees?:
What is your funding code?:
11 digit code starting with a 5 or 1
How Many hours of Funding is your child entitled to?:
What is the Funding code for your child?
Date you would like your child to start at Nursery*

DayMonthYear
Date
Please complete and submit this form to the Nursery Manager.

Your child’s name will be added to our waiting list on receipt of the £50 registration fee unless you are applying for your child to attend on a Basic Entitlement to Funding basis.

For those children requiring a fully funded Basic Entitlement place a £100 deposit is required.

For all other children including the out of school club, are required to pay a deposit of £150 to our bank account: Hopscotch Day Nursery, Sort Code: 40-13-22, Account: 41548646.

All deposits are held by us and refunded against your child’s final invoice. Deposits paid are non refundable if a place is not taken up within the agreed timescale.

I agree to abide by the procedures of the Nursery and understand that there is a minimum one-month notice period in writing required upon leaving or changing sessions and times that my child attends.
Print Name:*
Relationship to child:*
Signature*

Clear
Date*

DayMonthYear
Date
Should be Empty: