Mini Me’s Preschool Registration Form

Child’s Full Name:Name known as:

Male/Female. Nationality:First Language: List any others known or spoken at home:

Age……Date of Birth………..… Birth Certificate seen: Yes/No Religion:

Name of Parent(s)/Carer(s) with whom the child lives with:

Contact 1Parent/Carer Full Name:

Relationship to child:

Home Phone No……………………………Mobile………………………………...

E-mail Address ……………………………………………………………………….

Home Address………………………………………………………………………

………………………………………………………………..Post code…………

Place of employment (if any)……………………………………………………..

…………………………………………………Work No……………………………

Contact 2 Parent/Carer Full Name:

Relationship to child:

Home Phone No……………………………Mobile………………………………...

E-mail Address……………………………………………………………………….

Home Address………………………………………………………………………

………………………………………………………………..Post code……………

Does this parent/carer have parental responsibility YES / NO (please circle one)

Place of employment (if any)……………………………………………………..

…………………………………………………Work No……………………………

Is there anyone who has restricted access to the child? Yes/No(please circle one)

It is important that the Preschool is informed of anyone else besides named parents/guardians, who are authorised to collect your child and contact in emergency if we are unable to contact you. Children will only be released into the care of authorised adults over the age of 16.

Other adults authorised to collect my child and in emergencies:

Name…………………………………………………Tel no:………………………... Relationship to child…………………………………………………………………..

Name…………………………………………………Tel no:………………………... Relationship to child…………………………………………………………………..

Name…………………………………………………Tel no:………………………... Relationship to child…………………………………………………………………..

Has your child received the routine childhood immunisations at these ages? (Please circle all relevant)

At birth Y//N2 months Y/N3months Y/N4months Y/N

12-13months Y/N3-4 year old Y/N

Has your child’s red health book been seen? Book startbook bag provided Y/N

Has your child had their two year old progress check with a Health Visitor? Y/N.

If yes please can you provide us with the summary?

Does your child suffer from any known medical conditions? Y/N-please give details

Does your child have any Allergies? YES / NO (please give details)

Does your child have any special dietary needs or preferences? YES / NO(please give details)

Does your child have any special needs or disability? YES / NO (please give details)

If yes please specify

Speech and language Physiotherapy Other

Are any of the following in place for your child?

SEN Support Education, Health and Care Plan Statutory Assessment

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

Is your child (please circle) In Nappies Potty Training Toilet Trained

Favourite Toy…………………………… Favourite book…………..………………

Favourite song…………………………Other likes

Has your child any particular fears/ dislikes? YES / NO (please give details)

Names, ages, gender of other children in your family

Any other information we should know (special words they use, or what comforter they use and when)

Any other agencies in touch with your family:

I am aware that sun cream will not be applied to my child unless discussed- When needed this should be applied by child’s carer before the session starts.

Parental Permission

I authorise the preschool staff to take my child to hospital in the case of an accident or emergency. Please state clearly if you have any objections to this below.

I authorise the preschool staff to give my child emergency medical treatment and/or first aid.

Staff do regularly take photographs of the children during their play. These photos are shared with you and used for the child’s individual development records within the setting. Group activities involving more than one child may appear in the relevant child’s journals. We may also record events and activities on video. Photos and videos are stored on the setting/managers computers only. Photos or group photos of your child taking part in activities may occasionally be used for promoting the preschool.

Please discuss with staff if you have any objections with this.

I authorise my child to be taken on organised short distance trips and general outings with the preschool.

Please inform the Manager of any changes to the above information.

Signed………………………………………………Parent/guardian Date…………………………………………

Has a settling in process been agreed? Datails:

Any further information that may help us to care for your child?

Mini Me’ Payment Policy

There is a one off registration payment of £35.00; once you are registered your child will be provided with a Mini Me’s t-shirt. Fees are £18 per sessions and £36 for full day. Sessions run Monday to Friday term time only. Fees are due two weeks in advanced payment, paid in full when registering or on the first day your child attends. We take cash or cheques made payable to Mini Mes’s Preschool (receipts will be given). Additional t-shirts can be purchased at £8 each and jumpers £12 each. T-shirts or jumpers with our Mini Me’s logo on are to be worn every day and this is the preschools uniform.

Money should be paid on the first day of the week your child attends if choosing to pay weekly or you can pay for the term or half term in advance. If payment is not received your child shall notbe able to attend.

The days your child is booked in for will be set and will remain the same each week, because the place is a permanent place. It is not possible to book your child into the preschool on different days each week. Your child will remain booked into the preschool until you give us notice of four paid weeks that you wish to remove him/her from it.

Fees are subject to a yearly review and may increase slightly in the month of April or if a situation arises out of our control at which parents would be informed of the reason.

Please phone in and notify staff if your child will not be attending due to any reason.

If a child does not attend a booked place, money will not be refunded. Money paid cannot be transferred to another day. This also applies if your child does not attend due to:

Holiday: 25% discount will be given for one week as long as one month’s written notice is provided to playgroup supervisor. Fee’s are still due on Bank Holidays.

Sickness: 50% discount will be given if the child’s absent is due to a contagious disease, (not including general illness such as colds and sickness) provided that the parent/carer produces a doctor’s note/certificate and advises the preschool immediately.

When paying by Childcare voucher scheme a £35 admin fee will be applied once per year if paying termly, if paying half termly or weekly the £35 admin fee will be applied each half term. This is due to the extra admin that this creates.

Children attending Mini Me’s are only insured to be in the preschool from 9.15 to 15.15. It is therefore the policy of the preschool that if a parent is more than 10 minutes late to collect their child they will be fined £10.00 and then £20.00 for the next 20 minutes, after which social services will be contacted if no contact has been made from the parent/carer to advise the preschool of lateness.

Should payments be over a week late you will incur a late payment fine of £5 per week, this is to stop the extra admin this creates so please do pay on time. These fines are non-negotiable.

We all look forward to welcoming you and your child into our preschool and hope you find it of benefit and your child enjoys learning through play with us.

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

Date……………………………………………….