Child Registration Form

    Step 1 :Child’s Details

    Date Of Birth :

    Gender :



    Home Address:



    Step 2 : Parent/Carer 1 with whom the child lives


    Does this person have parental responsibility?

    Contact Details:



    Step 3 : Parent/Carer 2 with whom the child lives (if applicable)


    Does this person have parental responsibility?

    Contact Details:



    Step 4 :Any parent with whom the child does not live:


    Home Address


    Contact Details


    Does this parent have legal access to the child?

    Step 5: Emergency Contact (other than above):



    Contact Details


    Step 6: Additional Information:

    People who may collect your child

    Child’s School:

    Health Visitor:


    Child’s Doctor:

    Surgery:

    Phone:


    Does your child have:

    On-going health problems?

    Special needs that staff should be aware of?

    Allergies or special dietary requirements?

    A child protection plan?

    A CAF Plan (Common Assessment Framework)

    First Aid Treatment:

    I give permission for my child to receive first aid treatment from appropriately qualified staff:

    Is your child allergic to plasters?

    I give permission for my child to be taken to hospital by ambulance and to be given treatment by Paramedics / hospital staff in an emergency:

    Observations:

    I give permission for observations to be made on my child while in the setting for the purpose of activity planning.

    Photographs & Videos:

    I give permission for general photographs and video recordings to be taken of my child for the following purposes:

    Displays within the setting :

    Children’s learning record files

    Local paper / news letters

    By using this form you agree with the storage and handling of your data by this website.