Pre-School Registration Form

TOYBOX PRE-SCHOOL REGISTRATION FORM

(CONFIDENTIAL)

Name of child______Date of birth ______

Name know as ______Gender (M/F) ______

(Please note we need a copy of your child’s birth certificate, passport, or European Identity Card)

Address child usually lives at ______

______

Postcode ______Home telephone number ______

The Early Years Foundation Stage (EYFS) requires us to establish who has parental responsibility and legal contact with the above named child as defined below.

Parental responsibility

Mothers automatically have parental responsibility. A married couple who have children together automatically have parental responsibility. Parental responsibility continues during separation and after a divorce. Where the parents are not married the father has parental responsibility if his name is registered on the birth certificate (post 01/12/2003); if he marries the mother; if he obtains a Parental Responsibility Order from the court or if he has a Parental Responsibility Agreement with the mother.

Legal contact/contact orders

Legal contact is a court order that has been granted to anyone who has applied to a court for access to a child and has been given legal contact rights.

Looked After Children (LAC)

Children become’looked after’ if they have either been taken into care by the local authority, or have been accommodated by the local authority under a voluntary arrangement. Most LAC will be living in foster homes, but a smaller number may be in a children’s home, living with a relative or even placed back home with their natural parent(s). When a child is made the subject of a care order, the local authority has legal responsibility for the child.

Private Fostering

If a child is living with an adult who is not their parent or a close relative this may be private fostering. This is a private arrangement made between parents and a cares for 28 days or more. If you are privately fostering a child you need to notify the Local Authority on 01473 583000.

Who does the child live with?

1. Parent/carer with whom the child lives (i.e., Mum or Dad)

Name:
Relationship to child:
Date of birth: / National Insurance Number:
Does this parent/carer have parental responsibility?
(Are they named on the birth certificate or have a Parental Responsibility Agreement?) / Yes/No
Mobile phone number:
Work phone number:

1. Parent/carer with whom the child lives (i.e. Dad or Mum)

Name:
Relationship to child:
Date of birth: / National Insurance Number:
Does this parent/carer have parental responsibility?
(Are they named on the birth certificate or have a Parental Responsibility Agreement?) / Yes/No
Mobile phone number:
Work phone number:

1. Parent with whom the child does not live (i.e. Mum or Dad)

(Not all children have a parent who they do not live with)
Name:
Relationship to child:
Does this parent/carer have parental responsibility?
Are they named on the birth certificate or have a Parental Responsibility Agreement?) / Yes/No
Does this parent/carer have legal access to the child?
(Have they applied to a court and been access to the child and been given legal contact rights?) / Yes/No
Address
Telephone / Mobile
Other people with access to the child:

1. Does anyone else have legal access to the child? If yes, please give details below and provide a copy of the Court Order.

/ Yes/No

1. Is this child a Looked After Child (LAC)? If yes, please give details below, including Social Worker name and contact details.

/ Yes/No

1. Is this child in a private fostering arrangement? If yes, is the arrangement registered with the Local Authority? Please give details below, including Social Worker name and contact details

/ Yes/No

1. Does your child have a social care worker for any reason?

/ Yes/No
Name:
Where are they based?
Telephone / Mobile

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

1. Does your child have a Child Protection Plan? If yes, please give details below.

/ Yes/No

1. Does your child have a Child in Need Plan? If yes, please give details below.

/ Yes/No

1. Is there anyone who MUST NOT have access to the child? If yes, please give details below and provide a copy of the Court Order.

/ Yes/No

EMERGENCY CONTACT DETAILS

What are the best numbers to contact you on if your child is ill?

First parent/carer to contact:
Daytime phone number (work/home/mobile)
Second parent/carer to contact:
Daytime phone number (work/home/mobile)
Emergency Contacts
Who could we contact if your child is ill and we cannot get in contact with you?
Name / Name
Relationship with child / Relationship with child
Telephone / Telephone
Mobile / Mobile
Persons Authorised by you to Collect the Child (must be over 16 years of age)
(Who might you ask to collect your child if you are unable to collect them?)
Name / Name
Relationship with child / Relationship with child
Telephone / Telephone
Mobile / Mobile
We must be informed in writing or by telephone (in an emergency) if anyone other than yourself or persons indicated on this registration form is to collect your child. They must know the password you provide us and also show ID, e.g. drivers licence.
PASSWORD
Are you happy for staff or directors to contact you by email?
Email address / Yes/No
Are you happy for your email address to be included on a parents contact list? / Yes/No

PERSONAL DETAILS OF THE CHILD

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

1. What, if any, religion do you practise in your family?

1. 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?

1. Are there any festivals or special occasions not celebrated in your culture that your child SHOULD NOT take part in that we might acknowledge and celebrate while he/she is in our setting? (i.e. birthdays and Christmas and Easter for Jehovah’s Witnesses)

1. What language(s) is/ are spoken at home?

1. 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?

If YES please discuss this with your child's Key Person and agree how we will support your child when settling in.
For example, it may be important for your child that you show him/her where the toilets are, as they will understand you. / Yes/No

1. 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

Extra help your child may need

1. Does your child have any needs or disability? (i.e. hearing problems, speech difficulties, hyper mobility, cerebral palsy, etc)

/ Yes/No

1. Does your child have any medical condition? (i.e. asthma, eczema, cystic fibrosis, etc)If yes please give details.

/ Yes/No

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

1. Does your child have a plan setting out how they will need to be supported with the Graduated Response to Special Educational Needs? (Formerly known as IndividualEducation Plan to support your child at Early Years Action, Early Years Action Plus or with their Education Health Care Plan (formerly known as Statement).

/ Yes/No
If yes, please bring us a copy of your child’s most recent paperwork relating to the support they will need for their Special Educational Needs or Disability so we can work alongside you and his/her other professionals.

1. Does your child have any allergies or food intolerances or any special dietary needs (such as religious reasons to avoid pork or beef)?

/ Yes/No
If yes, please give details.

1. Name, address and telephone number of GP

Address
Telephone

1. Name, address and telephone number of Health Visitor

Address
Telephone

1. Are any other professionals (e.g. speech therapist, paediatrician, portage, dietician, educational psychologist, physiotherapist) involved with your child?

If yes please provide details. / Yes/No

1. Are Immunisations up to date?

/ Yes/No

1. Which Children’s Centre(s) are you registered with?

1. Would you like to receive information about Children’s Centre services?

(The Children’s Centre can help with various matters e.g. Toddler Groups, Breastfeeding, Health Visitors and other support) / Yes/No

CONSENT AGREEMENTS FOR PARENTS/ CARERS

Name of Child
Date of Birth
Name of Parent/Carer
Date
Emergency Medical Incidents
The Early Years Foundation Stage requires us to seek consent for emergency medical incidents.
I give consent for emergency medical advice to be sought and for treatment to be given to my child as deemed necessary by the medical profession. If hospital treatment is required transport will be arranged either by ambulance or by accompanying the child in a taxi.
Signed
Photographs within Learning Journeys
Photographs and video are a valuable method of recording a child’s time at the setting and are used for assessment purposes within the child’s individual Learning Journey. Sometimes photographs include your children’s friends if they are playing together, in order for photographs to be shared between families, we therefore seek consent for your child’s image to appear in other children’s Learning Journeys.
I do/ do not give consent for my child’s photograph to be taken? / Signed
I do/ do not give consent for my child’s photograph to be taken and used within their Learning Journey? / Signed
I do/ do not give consent for photographs of my child to be taken and used in other children’s Learning Journeys. / Signed
I do/do not give consent for video of my child engaged in play to be used as a form of observation. / Signed
Photographs for Other Purposes
From time to time we use children’s photographs within our settings displays.
I do/ do not give consent for my child’s photograph to be taken and used within displays. / Signed
From time to time the local press may come to take photographs in the setting, to feature in the newspaper, with full names of the children.
I do/ do not give consent for my child’s photograph to be taken and full name used within the local press. You will be informed if the press are due to come into the setting. / Signed
We have professional photographers come in 3 times a year to take photographs of the children for their parents/carers to buy – we will display posters letting you know when they are to come and put the dates in the newsletter. You do not have to buy the photographs.
I do/ do not give consent for my child’s photograph to be taken by visiting professional photographers. You will be informed when the photographer is due to visit Toybox. / Signed
Learning Journeys
To ensure we meet the needs of all children in our setting it may be necessary at times to seek advice from other professionals on how we can adapt our practice and environment to meet those needs.
I give permission for my child’s My Learning Journey and video observations to be shared with the primary school that my child will attend and with other professionals such as Speech and Language therapists, Educational Psychologists, Social Care Workers, Healthcare and Educational professionals and other child carers used by the family, for example a childminder or another early years setting.
Signature / Date
Outings
On a regular basis we walk the children from Toybox Preschool to the nearby play area and the shops and the primary school field to participate in outdoor play. We have carried out a full risk assessment to ensure the children’s safety is paramount and this is available for you to see.
From time to time we take children on local walks and visits in the neighbourhood to support children’s learning and experiences; this may for example include visits to the local park and shops.
I do/ do not give consent for my child to take part in local outings, please note for outings outside of the local area additional consent will be sought. / Signed
Use of Plasters
I do/ do not give consent for hypoallergenic plasters to be applied to my child when deemed necessary by the Playgroup staff. / Signed
If your child has an allergy or intolerance to hypoallergenic plasters, please discuss with the managers what else we can use if your child has a cut or graze that needs covering.
Application of Sun Protection Cream
We are committed to protecting children from the sun’s harmful rays whilst playing outside and expect you to apply sun protection cream to your child before bringing him/her to preschool each day in the summer. (As well as providing a sun hat.)
However on some occasions it maybe necessary for staff to apply or reapply sun protection cream to ensure they can play outside safely. This mainly applies to the children staying at Toybox all day or having dual placement with Toybox and Handford Hall nursery class. The setting keeps a stock of Nivea Sun Kids Pure & Sensitive Sun Spray SPF 50+.
I do/ do not give consent for preschool supplied sun protection cream to be applied to my child’s exposed skin by the preschool staff. / Signed
If you would prefer your child’s own brand of sun cream to be applied during a session please ensure it is clearly labelled and inform staff. The setting keeps a stock of Nivea Sun Kids Pure & Sensitive Sun Spray SPF 50+.
I do/ do not give consent for home supplied sun protection cream to be applied to my child’s exposed skin by the preschool staff. / Signed
Observation of Children
As part of our commitment to provide for the individual needs of children we observe children on a regular basis. The preschool offers training placements for childcare students who, in order to complete training assessment will be required to observe and record children engaging in play.
I do/ do not give consent for childcare students to observe my child as detailed above. / Signed
Data Protection
I agree that Toybox Preschool may hold the information I have given for the purposes of managing the provision and I undertake to advise the preschool of any changes to these details. I understand that this information will be available to staff and management committee of Toybox and I may inspect the information relating to my child by giving reasonable notice to the Preschool manager.
Signature / Date
Special Occasions and Cooking Activities
I give permission for my child to eat treats brought into the setting to celebrate special occasions, and to sample foods used in our cooking sessions.
When we do cooking, we will make sure the recipes are suitable for all children or adapted for all children (i.e., we use dairy and soya free Sunflower Spread instead of butter).
If your child cannot have cakes and sweets that other parents/carers may bring in so the children can celebrate their child’s birthday or other special occasion, please speak to the managers so we can get something to keep in the kitchen that your child can have instead.
Signature / Date

MEDICATION CONSENT FORM

Name of child / Age & D.O.B.
Reason for medication / Name of medicine
Strength / Form of medication (syrup, drops, inhaler etc)
Prescribed by
(Check medicine is for named child) / Dosage
Frequency (TIME NEEDED FOR FIRST DOSE) / Date the medicine was supplied by parent
Storage procedures / Use before date
Possible side effects / Staff receiving the child's medication
IF YOUR CHILD HAS BEEN GIVEN THIS MEDICINE BEFORE ARRIVING AT NURSERY PLEASE GIVE TIME AND DOSAGE.
Special Notes
Notes
Medicines must be in original container as dispensed by the pharmacy.
Staff are not allowed to make any changes to the prescribed dosage on parental instruction.
If a child (especially under the age of two) has not had this medication before, it is advised that the parent keeps the child at home for the first 48 hours to ensure no adverse effect as well as to give time for the medication to take effect.
I hereby give my consent for ______member of staff to administer the above medication to my child, in the amount and at the times stated above.
Signed / Date
Please print name and relationship to child

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