Oakley Pre-school Registration

Oakley Pre-school Registration

2024-25
Child's Details:
Full Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Child's Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Who lives at this address with the child?
If the child splits their time between 2 addresses, please provide their secondary address, details of how their time is split, and how this will impact drop-offs and collections.
Please provide details of any siblings (names, ages & position in family)?

Child's Ethnic Background

Ethnic Code options:

WBRI	White British	APKN	Asian or Asian British Pakistani
WIRI	White Irish	ABAN	Asian or Asian British, Bangladeshi
WIRT	Traveller of Irish Heritage	AOTH	Asian or Asian British, any other background
WROM	Gypsy/Roma	BCRB	Black or Black British, Caribbean
WOTH	White, any other White background	BACFR	Black or Black British, African
MWBA	Mixed, White and Black African	CHNE	Chinese
MWAS	Mixed, White and Asian	OOTH	Any other ethnic background
MOTH	Mixed, any other mixed background	REFU	Did not wish to be recorded
AIND	Asian or Asian British, Indian	NOBT	Not obtained

Parent/Carer 1 (Registering Parent/Carer)
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
National Insurance Number
Address*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
Relationship to Child*
Place of Work
Work Telephone Number (if different to above)
Please enter a valid phone number.
Do you have Parental Responsibility for the child?*

YesNo
Does your child attend another setting (Nursery, Pre-school, Childminder etc)*

YesNo
If yes, please provide the name, address, contact phone number and details of how many days/hours your child attends there.
Does the child have a parent/carer who is a member of the Armed Forces?

YesNo

Parent/Carer 2
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address (if different to child)

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
Relationship to Child
Place of Work
Work Telephone Number (if different to above)
Please enter a valid phone number.
Does this individual have Parental Responsibility for the child?

YesNo
Is Pre-school authorised to release the child into the care of this individual?

YesNo

Emergency Contacts

To be used as an alternative if Parents/Carers are unavailable in an emergency.
Emergency Contact 1:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Child*
Is Pre-school authorised to release the child into the care of this individual?*

YesNo
Emergency Contact 2:

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to Child
Is Pre-school authorised to release the child into the care of this individual?

YesNo

Permission to Collect from Pre-school

OPTIONAL: Please list anyone else you would like to give permission to collect your child from Pre-school
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Is Pre-school authorised to release the child into the care of this individual?

YesNo
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Is Pre-school authorised to release the child into the care of this individual?

YesNo

Support Services
Is your child subject to any court orders? If yes, please provide more information & a copy of the court order in confidence to preschoolmanager@oakley.bucks.sch.uk.*

YesNo
Is your child or family under the support of Social Services, or Family Support Services/Early Help?*

YesNo
If yes, please provide more details here.
Is your family in receipt of one or more of the following (if yes, Pre-school is able to access additional funding for your child):

Income SupportIncome based job seekers allowanceIncome related employment and support allowanceChild tax creditUniversal Credit
If yes, please state the name, date of birth and National Insurance number of the parent in receipt.

Medical Information

In addition to the information below, please bring your child's medical record (Red Book) into Pre-school before their first settling in session.
Doctor's Name & Surgery Address*
Doctor's Phone Number*
Please enter a valid phone number.
Health Visitor Name/Details*
Health Visitor Phone Number*
Please enter a valid phone number.
Immunisations

Please write date your child received their immunisations. Please leave blank if you have chosen not to vaccinate your child.
2 months: Diphtheria, Tetanus, Whooping cough (Pertussis), Polio and Haemophilus influenza type b (Hib), Pneumococcal infection

DayMonthYear
Date
3 months: Diphtheria,Tetanus, Whooping cough (Pertussis), Polio and Haemophilus influenza type b (Hib), Meningitis C (meningococcal group C)

DayMonthYear
Date
4 months: Diphtheria, Tetanus, Whooping cough (Pertussis), Polio and Haemophilus influenza type b (Hib), Meningitis C (meningococcal group C), Pneumococcal infection

DayMonthYear
Date
12 months: Haemophilus influenza type b (Hib), Meningitis C

DayMonthYear
Date
13 months: Measles, Mumps and Rubella (German measles), Pneumococcal infection

DayMonthYear
Date
3 years 4 months to 5 years: Diphtheria, Tetanus, Whooping cough (Pertussis), Polio, Measles, Mumps and Rubella

DayMonthYear
Date
Non Routine (from Birth): Tuberculosis

DayMonthYear
Date
Non Routine (from Birth): Hepatitis B

DayMonthYear
Date

	Yes	No
I understand that Oakley Pre-school is a Nut Free Environment and agree to abide by this policy (including checking ingredients of packaged food sent in).

	Yes	No
I give permission for my child to take part in visits and walks within Oakley.

Final Declarations:
I confirm that all the information provided within this Registration Form is true and correct. *

Powered by Jotform SignClear
Name*

First NameLast Name
Date*

DayMonthYear
Date
Should be Empty:

	Monday	Tuesday	Wednesday	Thursday?	Friday
7.30am - 1.00pm
7.30am - 3.30pm
7.30am - 4.30pm
7.30am - 6.00pm
8.30am - 1.00pm
8.30am - 3.30pm
8.30am - 4.30pm
8.30am - 6.00pm
Legacy 9.00am - 1.00pm
Legacy 9.00am - 3.00pm
Legacy 1.00pm - 6.00pm
Legacy 7.30am - 3.00pm

	Yes	No
Audiologist
Community Paediatrician
Physiotherapist
Dietician
Health Visitor
Speech Therapist
Orthoptist
Occupational Therapist
Psychologist
Other

	Yes	No
I give consent for Oakley Pre-school to share information with specialists supporting my child or family
I give consent for Oakley Pre-school to pass this and other records onto my child's next setting
I give consent for Oakley Pre-school to share my and my child's data with third party system providers (e.g. Xero for invoicing, Tapestry for information about my child's day and Funding Loop for funding)

	Yes	No
I give permission for my child to be administered any non prescribed medication when needed (e.g. Pirition for allergic reaction or Calpol for pain/teething)
I give permission for my child to have adhesive plasters applied if necessary for first aid purposes
I give permission for Pre-school to seek urgent medical attention for my child if required, and in particular in the event of Pre-school being unable to contact me.

	Yes	No
I give permission for observations to be made and photographs to be taken of my child during Pre-school sessions for record keeping purposes. I understand these are stored and available to me through Tapestry.
I give permission for photographs of my child to be shared within the closed Pre-school Parents Facebook Group (access to which is monitored by Pre-school staff & committee).
I give permission for photographs of my child to be published as part of Pre-school's advertising (including but not limited to the Pre-school website, Facebook, Instagram, posters & prospectus).

Oakley Pre-school Registration

Regular Schedule Request

Parent/Carer 1 (Registering Parent/Carer)

Parent/Carer 2

Emergency Contacts

Permission to Collect from Pre-school

Support Services

Medical Information

Immunisations

Care information

Consents

Final Declarations:

	Yes	No
I agree to be added to the Pre-school email list, through which my email address may be visible to other parents.
I understand it is my responsibility to join the Parent's Facebook Group & the WhatsApp Announcements group.

	Yes	No
I understand that all Policies & Procedures are available at www.oakleypreschool.co.uk/policies-and-procedures using the password HappyChildren
I have read and accept the Admissions & Fee Policy valid on today's date
I understand that I must give 1 term's notice (or pay the fees for that term) if I wish to remove my child from Oakley Pre-school
I understand that I must give 1 term's notice to change the session my child attends

	Yes	No
I understand that Oakley Pre-school is a charity, and that on registration my family become Members of Oakley Pre-school CIO.
I understand that as part of the charity structure, Pre-school is led by a volunteer committee & I agree to help and support the committee where I can.