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Preston Village Hall, Preston Road, Preston, Weymouth, Dorset, DT3 6BH

Preston Pre-school Registration Form

You can also click here to download this form in PDF format to print.

Child’s Details

DD slash MM slash YYYY

Parent/Legal Guardian Contact Details

(Where appropriate, clarification of the legal guardian is required)
Title
DD slash MM slash YYYY
(required for funding purposes)
Does adult have parental responsibilityfor the child?(Required)

Please provide your childs birth certificate to the setting, this will be immediately returned after verification.

PERSON 2: Parent/Legal Guardian Contact Details

(Where appropriate, clarification of the legal guardian is required)
Title
DD slash MM slash YYYY
(required for funding purposes)
Does adult have parental responsibility for the child?

Other Person(s) with legal contact

(to be completed where those persons with parental responsibility are separated and/or an S8 order is in place)
Title
Does adult have parental responsibility for the child?

Parent’s Place of Employment Details

Ethnicity data gathered for monitoring purposes only.

Parents are not obliged to give this information. Ethnic origin is classified as special category of data under data protection legislation and we require your consent in order to process and store this information. The Privacy policy explains how the data provided in this form will be processed and explains your rights with respect to the information given.

Privacy Notice

I confirm that I have received a copy of the Privacy Notice and give my consent to the processing of special category data.
Please Select

Collection/Permission Authorisation

(other than parents) Please note that if the authorised person is not the person indicated on this form we will check before releasing the child. Only those over the age of 16 years can be named as authorised persons.

Authorised Person 1

Title
DD slash MM slash YYYY

Authorised Person 2

Title
DD slash MM slash YYYY

Authorised Person 3

Title
DD slash MM slash YYYY

Persons with no access to the child

(evidence must be provided)

Emergency Contact Details

(Three adults to whom your child can be handed over to or contacted in the event of an emergency)

Does/will your child attend any other settings or childminders?

Will childminder collect from Pre-school?

Password

The safety of your child whilst at Preston Pre-school is of paramount importance and therefore a password system is in place for the collection of children by anyone other than the nominated person. This password will be required in all instances that the child is collected by another person.

Religion

Language

Medical Information

Dates of Immunisations:

Is your child disabled?

Is our usual practice to provide both a meat and vegetarian option. If this is not in keeping with your child’s dietary requirements please discuss this with the setting manager to ensure that we are working in partnership with you to meet your child’s needs. Please refer to our nutrition procedures.

Emergency Treatment Declaration(Required)
In the event of an accident or emergency involving my child I understand that every effort will be made to contact me and emergency services will be called as necessary. I understand that my child may be taken to hospital accompanied by the manager or authorised deputy for emergency treatment. I understand that health professionals will be responsible for decisions about medical treatment in my absence.
For inhalers/auto-injectors (e.g. Epipens) only:
I give permission for a named member of staff who has been trained to administer the inhaler / Epipen or Anapen (supplied by me) to my child

Two year old progress check/Integrated health check

As per the requirements of the Early Years Foundation Stage we will complete a progress check on your child between the ages of 24-36 months. We will ask you to be involved in completing the check and to share it with your child’s health visitor. Please note that where a local authority has arrangements in place we complete an integrated check with you and your child’s health visitor.
If your child is aged between 24-36 months, has a two year old progress check already been completed for your child?(Required)
MM slash DD slash YYYY

Parental Consents

Please read each statement carefully, delete as appropriate and sign each statement individually. These statements are in accordance with the settings policies and procedures.

Medical Consents

Sun Tan Lotions/Nappy Cream(Required)
I do / do not give consent to Pre-school staff applying sun-tan lotion /nappy cream provided by pre-school, or myself, to my child.
Paracetamol / or Ibuprofen based medicine(Required)
I do / do not give consent to Pre-school staff administering paracetamol/ibuprofen based products to my child In the case of a raised temperature and on the understanding that I will be making arrangements for my child to be collected as soon as possible.
Photographs/Video at setting(Required)
I do / do not* consent to Pre-school staff taking photographs or videos of my child for inclusion within my child’s file and Tapestry Learning Journey, display purposes and labels within Pre-school. I am aware that my child may be in the background of another child’s photograph displayed in their file or in their Tapestry Learning Journey. Only equipment supplied by us is used for this purpose and images taken are for display and for your child’s learning records. Images are saved and stored on our equipment securely, and only kept for the period your child is with us.
Photographs/Video at setting (continued)(Required)
I do / do not give permission for my child’s photograph to be used by any media such as local newspapers/magazines.
E Safety(Required)
There are procedures in place that govern the use of IT equipment on site. Where i-pads or similar are used by staff to record children’s learning and development or as a management tool, a risk assessment is completed and only equipment owned by the setting is used. Visitors to the setting using IT equipment, such as Ofsted or Social Care, are advised of the procedure for its use and must seek prior permission from the setting manager. In some instances children will use ICT equipment to promote their learning and development under the supervision of staff. Children never have unsupervised access to the internet. I give permission for my child to use ICT equipment for the purposes stated above. I understand that there are procedures and risk assessment in place to govern its use and that staff and visitors may also use ICT equipment to record and monitor children’s learning and development.
Short trips/general outings(Required)
I do / do not* consent to Pre-school taking my child on short trips or general outings. e.g the local shop, church. Individual risk assessments are carried out for each trip and will be available to view if required.
We may occasionally have supervised visits of animals to our setting or have pets on site. We will ensure that our pets are healthy and are inoculated as appropriate and that animals showing any signs of disease are treated. Risk assessments will be carried out for visiting animals and will be made available to parents on request. Please state here any known allergies or aversion your child has to animals:
Nappy/Pull Up Changing(Required)
I do / do not consent to Pre-school staff changing my child’s nappy or pull up as required.
Nappy/Pull Up Changing (continued)(Required)
I do / do not* consent to Pre-school staff changing my child’s clothing (including underwear) should they become wet of soiled.

Snack Time

At Pre-school we provide a mid-morning snack for the children. The snacks offered are breadsticks, dried or fresh fruit, cereals, biscuits, cheese and we celebrate birthdays with some cake. Allergen information can be produced upon request. We provide milk or water to drink.
My child will drink(Required)
Transfer of Records(Required)
With your consent we will transfer your child’s records to the receiving school when they leave our setting. This will enable the school to continue to effectively manage any special education, health or medical needs, and to continue with their development.

Policies and Procedures

I am aware that Pre-school have Policies and Procedures which they adhere to through the EYFS and that I can have access to them at any time. I confirm that information about the setting’s policies and procedures has been made available and explained to me, and I understand I can find more information as to how my personal data is handled through the Privacy policy. Please sign below to indicate that the information on this form is accurate and that you will notify us of any changes as they arise.
This field is for validation purposes and should be left unchanged.