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ADMISSION FORM FOR WINYATES PLAYGROUP

To be completed in pen or typed by the parent and handed to the supervisor

 

Child’s name...........................................................................................Date of birth……............................

Home address.........................................................................................Post Code….................................

Mother’s name.............................................................................................Tel no.........................................

Mother’s contact address...............................................................................................................................

Father’s name..............................................................................................Tel no.........................................

Father’s contact address................................................................................................................................

Who & where to contact in an emergency.....................................................................................................

Name of person(s) who will collect child........................................................................................................

Name of person or body legally responsible for the child...............................................................................

Child’s doctor...............................................................................................Tel no.........................................

Address...........................................................................................................................................................

Immunisation / vaccinations............................................................................................................................

Please Confirm :-.....Meningitis (Y/N)?.....MMR (Y/N)?    

Infectious illnesses.............................................................................................................................

Health visitor.........................................................................................................................................

Any special diet, cultural requirements, allergies, health problems etc.

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

Anything else the group should know about your child

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

1.         I agree to my child being taken to hospital or to being seen by the nearest Doctor available should an emergency rise.

2.         I understand that my child will not be admitted to the playgroup if he/she is not well (including head lice or fever), and no sooner than 48hrs after vomiting.

3.         I agree to my child being taken out on an organised pre-school group trip, such as a local walk.

4.         My child does/does not attend another pre-school group

5.         My child will be attending ....................................................................................................   1st School

6.         I understand the Playgroup operates in accordance with its published Prospectus and Policies and that copies are available to me on request and on winyatesplaygroup.com.

7.         I agree to my child being included on Playgroup photographs which may be used for evidence of activities for OFSTED and monitoring, and may be published on the Playgroup website.

8.         We are promoting health foods such as fruit and vegetables.  Therefore, I understand my child will be given the opportunity to try new foods and tastes and I will inform a member of staff of any allergies that might arise, immediately.

9.         I confirm that I have received a copy of Winyates Playgroups Privacy Notice with this Admission Form.

 

Signed............................................Name.............................................. Date.......................

 

Enrollment Date (Playgroup supervisor).............................................

Winyates Playgroup Ltd, Unit 11 Winyates Centre, Redditch. B98 0NR.