Registration Form for BarBar At The Rosary

Name of Child:

Preferred Name:

Date of Birth:

Gender:

Any Special Needs or Disability:

Any Allergies including foodstuffs:

Home Address & Tel No.:

Name of Parents/ Carers and their relationship to child:

Parent/ Carer Contact Details (include Tel no.):

Name & Address & Tel no of GP:

Name of Health Visitor: 

Name of school attending (for ASC places only):

Emergency Contact- Name, Relationship & Tel no:

(if we are unable to contact the parent/ carer)

Person Authorised to collect the child- Name, Relationship & Tel no:

(if other than the parent/ carer)

Any additional information that you feel will help us to care for your child:

Agreements

Name of Child:

Date of Birth:

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_________________

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 ____________________________________

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.

Signed ____________________________________

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 ____________________________________

My child does/does not (please delete) have an allergy to Calpol

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

Signed _____________________________________

Signed on behalf of BarBar _____________________ Date___________

Contract of Child Care

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

Address and Contact Details..................................................................................

...............................................................................................................................

Wish for my child/ren to attend the BarBar Nursery Pre-school and Out of School Club on the following sessions as from ……………………….( Insert start date). This is for a full time/ term time only place (please delete one)

I agree to pay the fees, as shown above, (subject to any annual increase) a week in advance of any session that my child attends. I understand that if I do not pay fees within two weeks, my child’s place may be withdrawn.

There is a one off registration fee to be paid at the time of registration. This is £25.00 per child attending nursery or pre-school.  These fees are requred at the time of registration and once received a place for a child will be held.

Fees are payable in advance and by standing order.

I understand that fees are payable for every session booked regardless of whether my child attends or not. If I wish to cancel my child’s place, I will two months notice in writing, otherwise I understand that I will be charged. No fees are due when the setting is closed.

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…………………………...

Signed ……………………………………………………… Parent/Guardian

Signed …….......................on behalf of BarBar Date…………………...