Registration Form

It is helpful for key persons or managers to complete this form with the parent(s) when the child starts at the setting & at this time we will discuss with you your desired settling in procedures.

Basic details

Full name of child

 

Date of birth

 

Name known as

 

Gender (male or female)

 

Name of parent(s) with whom the child lives

1

 

Does this parent have parental responsibility? Yes/No (delete)

2

 

Does this parent have parental responsibility? Yes/No (delete)

Address

 

 

Telephone

Email address

 

Mobile

 

Name of parent with whom the child does not live

 

 

Does this parent have parental responsibility? Yes/No (delete)

Address

 

 

Telephone

Email address

 

Mobile

 

Does this parent have legal access to the child? Yes/No (delete)

 

Emergency contact details

 

Parent 1 - Work/daytime contact number

 

Parent 2 - Work/daytime contact number

 

Any other emergency contact numbers

 

Name

 

Telephone

 

Mobile

 

Name

 

Telephone

 

Mobile

 

Persons authorised to collect the child (must be over 16 years of age)

Name

 

Relationship to child

 

Telephone

 

Mobile

 

Name

 

Relationship to child

 

Telephone

 

Mobile

 

Personal details of child

Does your child have any special dietary needs or preferences? Yes/No (delete)

 

How would you describe your child's ethnicity or cultural background?

 

What is the main religion in your family?

 

Are there any festivals or special occasions celebrated in your culture that your child will be taking part in and that you would like to see acknowledged and celebrated while he/she is in our setting?

 

What language(s) is/ are spoken at home

 

If English is not the main language spoken at home, will this be your child's first experience of being in an English-speaking environment? Yes/No (delete)

If so, discuss and agree with the key person how you will support your child when settling-in:

 

Does your child have any special needs or disabilities? Yes/No (delete)

Details

 

Are any of the following in place for the child:

Early Years Action?                                                  Yes/No (delete)

Early Years Action Plus?                                          Yes/No (delete)

Statement of special educational need                  Yes/No (delete)

What special support will he/she require in our setting?

 

 

What other information is it important for us to know about your child? For example, what they like, or what fears they may have, any special words they use, or what comforter they may need and when.

 

Names of professionals involved with child

Name 1

 

Role

 

Agency

 

Telephone

 

Name 2

 

Role

 

Agency

 

Telephone

 

Name 3

 

Role

 

Agency

 

Telephone

 

Do you have a health visitor?

Yes/No (delete)

Name

 

Based at

 

Telephone

 

 

 

Does your family have a social care worker for any reason?

Yes/No (delete)

Name:

 

Based at:

 

Tel:

 

 

 

What is the reason for the involvement of the social care department with your family?

 

 

 

NB If the child has a child protection plan, make a note here, but do not include details. Ensure these are obtained from the social care worker named above and keep these securely in the child's file.

To be completed by the key person/manager

Date starting at

 

(name of setting)

Days and times of attendance

 

 

Are any fees payable? If so, note here

 


www.barbarnursery.co.uk

Agreements

Name of Child:                                                          Date of Birth:                                    

1.       I give permission for the staff at BarBar to act in loco parentis in the case of a medical emergency where any delay in getting my signature is considered by a doctor to endanger my child’s health and safety.

Signed ____________________________________ Date_________________

2.       I agree for my child to be photographed whilst at BarBar and for such pictures to be displayed in promoting the provision, both on paper and web site materials.

Signed ____________________________________

3.       I agree for my child to be taken outside daily to the BarBar garden and out of BarBar to the town, Tesco, park or swings or within the immediate locality of the setting.

Signed ____________________________________

4.       I agree for my child to be taken out of BarBar on organised trips, outings and activities. I agree to my child being taken on public transport and carried in a vehicle covered by the Nursery insurance. (For these events, additional information will be given and parents will be notified beforehand)

Signed ____________________________________

5.       I agree to allow suntan cream to be applied to my child’s skin, but I understand that I must supply a cream that I know to be suitable to my child’s skin.

Signed ____________________________________

6.       I       give/do not give    (please delete) permission for my child to be given Calpol in the case of an emergency.

Signed _____________________________________

7.       I understand that all the information I have provided here will be treated as confidential. I also understand that if a matter of safeguarding my child arises, the Nursery may need to share aspects regarding my child without my consent.

Signed _____________________________________

8.       I agree not to discuss any aspects linked with BarBar Nursery on any internet chat rooms.

Signed _______________________________

Signed on behalf of BarBar   _____________________     Date___________

 

Contract of Child Care

I ………………………… As Parent/Guardian of ……………………………………………..

Wish for my child  to attend the BarBar Nursery on thefollowing sessions/times during term time only/ all year around   (delete as necessary) starting on……………………………

(Please tick attendance sessions in boxes below)

Please indicate if you wish for your child to be served a hot cooked meal at lunchtime- this is £2.00 per day

 

Monday

Tuesday

Wednesday

Thursday

Friday

8.00-8.30am

 

 

 

 

 

8.30-1.00pm

 

 

 

 

 

1.00-5.30pm

 

 

 

 

 

5.30-6.00pm

 

 

 

 

 

8.30-5.30pm

 

 

 

 

 

ASC 3-5.30pm

 

 

 

 

 

Fees are paid monthly in advance by standing order. 

I agree to pay the fees, as shown above, (subject to any annual increase) monthly in advance of any session that my child attends. I understand that if I do not pay fees within seven days, my child’s place may be withdrawn & I will be charged as additional £10.00.  Reminder letters for fee payments are charged for administration at £10.00 per letter. We use a debt recovery Agent to reclaim unpaid monies & for doing credit checks as required.

There is a one –off non refundable administration fee of £40.00 per child to secure a place (& £100 to hold a place- if applicable), & this is payable at the time of registration either by cash or cheque.

I understand that fees are payable for every session booked, including sickness regardless of whether my child attends or not. If I wish to cancel or reduce the hours of my child’s place, I will give two calendar months notice in writing; otherwise I understand that I will be charged. Parents are required to inform the setting if their child is absent and failure to do so may incur a £3 charge.

No fees are charged when the setting is closed-i.e. Bank Holidays, 24th December & the period between Christmas and the New Year. We open during snow for which fees are chargeable.

  • Children must be signed into BarBar and signed out of BarBar on a daily basis and the correct times added. We are responsible for them whilst they are signed into the setting.

  • Children are requested not to bring toys, games and valuables into BarBar. If they do, the setting is not responsible for any damage caused to or by the articles.

  • Children’s personal details must be updated immediately any changes occur

  • For safety and security reasons, I understand that the setting will not release my child to someone who is not known or authorised to collect my child unless they

            Use my security password which is…………………………............................................

I have read and understood the above list of BarBar policies and I agree that my child and I will abide by them. BarBar have further policies and procedures that I can view at any time; should I wish to view these I will ask a staff member.

I have read, understood & accept all the above statements and charges and agree to pay them.

Signed ………………………………………… Parent/Guardian Date……….....................