REGISTRATION FORM
PLEASE COMPLETE IN BLOCK CAPITALS AND RETURN TO PRE-SCHOOL
*Delete as necessary
Date of Application:…………………….……………………………………………………………......
Full Name of Child:………………………………………………………………………………………
Preferred Name to be used at Pre-School: …………………………………………………………..
Date of Birth:……………………………………………… ………………Sex: *Male / Female
Child’s Home Address:………………….………………………………………………………………
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………………………………………………………………………………Postcode:…………………
Home Telephone Number………………………………………………………………………………
Who has parental responsibility for this child?……………… ……………………………………….
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Full Name of Parents/Guardians: *Mr /Mrs /Miss /MsOther………………………………………
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Parent’s Name/s: ……………………………………......
Address:…………………………………………………………………………………………………………………...…………………………………………………………Postcode………………………...
Telephone Number…………………………….Mobile Number:……… …………………………….
Email ………………………………………………………………………………………………………
If your child has one parent living elsewhere, what is their address?......
………………………………………………………………………………Postcode…………………..
Telephone Number…………………………….Mobile Number:……… …………………………….
Is there any further information about who has legal contact with your child, which you would like us to know? Is there a court order in place for this?......
……………………………………………………………………………………………………………………………..……………………………………………………………………………………………….
Is your child subject to any of the following? (Please indicate)
Team around the Child Plan………………………..Child in Need Plan……………………………..
Child Protection Plan………………………………..Looked after child Plan………………………...
Does your child suffer from any allergies?......
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Details of their reaction…………………………………………………………………………………..
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Medication required………………………………………………………………………………………
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Details of any training required………………………………………………………………………….
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Does your child have any dietary requirements,food intolerancesor food preferences? Or any special requirements relating to clothing, health, religion, or other matters……..…………………
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Is there any background information regarding your child which may help us to understand them? E.g. brothers, sisters, pets, likes/dislikes. Any special words (For e.g. toilet, family members), any fears, events or changes in circumstance that may affect your child (this information will be kept confidential)
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Day time Emergency Contacts: (In order of contact)
ALL CHILDREN MUST HAVE TWO EMERGENCY CONTACTS
PARENTS ARE ALWAYS CONTACTED FIRST; THESE WILL ONLY BE USED IN EMERGENCIES.
Please provide a password to be used in an emergency……..………………………………..
1st Contact:
Name: ….……………………………………Relationship to Child: ………………………………….
Address:……………………………………………………………………………………………….….……………………………………………………………………………Postcode…………………….
Telephone Number……………………………….Mobile Number:…………………… ……………
2nd Contact:
Name:…………………… …………………Relationship to Child:…………………………………..
Address:……………………………………………………………………………………………….….……………………………………………………………………………Postcode…………………….
Telephone Number…………………...……….….Mobile Number: ………………………….……….
Child’s first language:………………………………… …..……………………………………………
Other languages spoken at home:…………….………………………………………………………
Child’s Religion:……………………………Child’s Ethnicity: ……………………………………….
Names or persons authorized to collect child from Pre School:……………………………………
……………………………………………………………………………………………………………………………………………………………………………………………………………………………..
(Photographs are required of all collectors or the password provided will be used in an emergency)
What is your child’s Previous/present Early Years Setting:………………………………………….
Which Primary school do you hope your child will attend?......
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Name of any brothers or sisters attending this school:……………………………………………...
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Name of child’s Doctor ….……………………………………………………………………………….
Address:……………………………………………………………………………………………………………………………………………………………………………………………………………………
Telephone number……………………………………………………………………………………….
Name of Health Visitor.………………………………………………………………………………….
Is your child up to date with immunizations? *Yes /No
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Does your child have any of the following? (Please indicate)
Visual difficulties…………………………………...Hearing difficulties……………………………….
Speech difficulties…………………………………Physical difficulties……………………………….
Hay fever……………………………………………Asthma…………………………………………….
Epilepsy……………………………………………..Diabetes…………………………………………..
Major illnesses……….……………………………………………………………………………………
Does your child have any ongoing health or medical problems which require medication?
Yes /No
What is the medication and how is it prescribed?……………………….…………………………...
……………………………………………………………………………………………………………..……………………………………………………………………………………………………………..
Please note Pre-school staff will only administer medication which has been prescribed by a doctor or other health professional
Does your child have any special medical requirements? If so, please state what these requirements are………………………………………………………………………………………….
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Our Pre-School has a Special Needs policy. Does your child have any Special Needs you would like to discuss with staff?......
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This admission form will be placed in a waiting list file. You will be contacted when a place becomes available for your child.
We welcome parents to come and visit Little Acorns @ Our Lady & St Oswald’s Pre-School. Please contact us if you wish to come and look at our Pre School, prior to your child starting Pre-School and see how our sessions are run.
Please Note. Our Lady & St Oswald’s Catholic Primary School have an Admissions Policy. If you wish your child to attend the school you may wish to discuss this policy with the Head teacher.
Parent’s signature:………………………………………………………..Date:…………………….
Received by:…………….…………………………………………………Date:………………..…….
Please could you complete the slip indicating which hours you wish your child to attend Little Acorns Pre-School?
The session times are: Morning session 9.00-11.30
Lunchtime 11.30-12.30
Afternoon session 12.30-3.00
Pre-School opens at 8.30am, and finishes at 3.30pm for anyone wishing to use these extra times.
Fees are £3.00 per hour; this also applies to the lunch hour.
From the term aftertheir third birthday, children are entitled to 15 hours of funding per week; these hours can include the lunch hour.
Thank you
Cheryl Meddins
(Pre-School Leader/Manager)
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Please indicate the sessions you wish your child to attend Pre-School
Child’s Name......
Date of Birth......
Extra hours8.30-9.00 / Funded session
9.00-11.30 / Lunch time
11.30-12.30 / Funded session
12.30-3.00 / Extra hours
3.00-3.30 / Starting Date
Monday
Tuesday
Wednesday
Thursday
Friday
Could you indicate in the box below (with start dates) the sessions you intend your child to attend in the future if they differ from above?
Start date……………………………………………………………………………………………..
Extra hours8.30-9.00 / Funded session
9.00-11.30 / Lunch time
11.30-12.30 / Funded session
12.30-3.00 / Extra hours
3.00-3.30 / Starting Date
Monday
Tuesday
Wednesday
Thursday
Friday
Please read and sign the following consent form:
Please indicate any you are not happy to consent to.
- Observations will be recorded on the children for assessment and planning. Occasionally observations will be made by people other than Pre-School staff e.g. college students. Children’s names will not be included in any observations made by students. Occasionally observations made by Pre-School staff may be shared with outside agencies, for example Area Special Needs Co-coordinator or Speech and Language therapist
- When children leave Pre-School, to attend another setting, we pass on any relevant information to the setting, with regard to individual children. Also, occasionally, information regarding individual children may be passed on to other Early Years Professionals within a specialised field.
- We regularly take photographs of children at Pre-School; for displays, Learning Journeys etc. These also, may be put on the Pre-School website.
On occasions the local newspaper or other media take photographs of events taking
place at Pre-School which may be published.
- In order for children’s Learning Journeys to be updated regularly it will occasionally be necessary for their Key Person to take photographs home.
- We occasionally take the children on walks within the local area; library, shops, park. We ensure there is a good child: adult ratio, usually one adult to two children, unless a different ratio is felt sufficient by the staff member in charge.
- In the event of an emergency, if at any time when parental consent cannot be obtained,
medical or surgical treatment, deemed necessary, being administered by a qualified medical practitioner, hospital staff, or to first aid being administered by a named member of staff being qualified in paediatric first aid.
- Pre-School will supply factor 50 AmbreSolaire sun cream to all children. The sun cream will be applied by a member of staff. If your child has an allergy to this sun cream you are required to supply sun cream for your child.
- In the event of an emergency, for example high temperature, paracetamol, in the form of calpol, being administered to my child by a qualified Pre-School first aider.
I ………………………………………………………………………………………………..parent/carer
of (name of Child)………………………………………………………………… give my consent to all the above points.
Signed …………………………………………………………….Date ………………………………..
Programme of terms and holidays for 2013/2014
Autumn Term 2013
PD Day Monday 2nd September 2013
Term starts Tuesday 3rdSeptember 2013
Half Term Monday 28th-Friday 1st November 2013
PD Day Friday 25th October 2013
Term ends Friday 20th December 2013
Spring Term 2014
Term starts Monday 6th January 2014
Half Term Monday 17th February-Friday 21st February 2014
Term ends Thursday 10th April 2014
PD DayFriday 11th April 2014
Summer Term 2014
Term starts Monday 28th April 2014
Bank Holiday Monday 5th May 2014
Half Term Monday 26th May-Friday 30th May 2014
Term end Thursday 17th July, 2014
PD Day Friday 18th & Monday 21st July 2014
PD Days Monday 2nd September 2013
Friday 25th October 2013
Friday 11th April 2014
Friday 18th July 2014
Monday 21st July 2014
Bank Holidays
Good Friday 18th April 2014
Easter Monday 21st April 2014
May Day 5th May 2014
Late May Bank holiday 26th May 2014
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Little Acorns Prospectus, Updated August 2013
Ofsted number EY232143
Charity number 1130949