Registration form

Registration Form

A normal signature will requested on the first day of your child starting with Chudleigh Pre-School.

Child's Full Name (hereafter referred to as 'child' *

First

Last

Name Known as (if different from above)

First

Last

Sex: *

Date of Birth: *

1. Name of Parent/s whom the child lives: *

2. Name of Parent/s whom the child lives:

Does Parent 1 have parental responsibility? *

Yes
No

Does Parent 2 have parental responsibility?

Yes
No

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Telephone *

Mobile *

Email *

I give permission for the above email address to be linked to my child's tapestry account so that I have access to my child's learning journal. (If you do not have access to an email we will make arrangements for your to view your child's learning journey at a mutually convenient time.) *

Yes
No
I do not have access to an email account.

Other

Name of Parent whom the child does not live?

First

Last

Does this Parent have parental responsibility?

Yes
No

Does this Parent have legal access?

Yes
No

Address of this parent.

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Telephone

Mobile

Emergency Contact Details

Parent 1 - work/daytime contact number *

Parent 2 - work/daytime contact number

Other Emergency Contact Name

First

Last

Relationship to Child

Telephone Number

Mobile

Other Emergency Contact Name

First

Last

Relationship to Child

Telephone Number

Mobile

Adults authorised to collect the child on a REGULAR basis (eg. Childminders)

Contact Name

First

Last

Relationship to Child

Telephone Number

Mobile

Contact Name

First

Last

Relationship to Child

Telephone Number

Mobile

Child’s ethnicity, cultural background and religion *

Are there any festivals/special occasions celebrated in your culture you would like to see acknowledged and celebrated while s/he is in our setting? *

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

If English is not the main language, is this your child’s first experience of an English-speaking environment? *

Yes
No
Not applicable

Is additional support required? (this support can be discussed) *

Yes
No

Which Primary School do you hope your child will be attending? *

I give permission for Chudleigh Pre-school to create an online tapestry journal and monitor my child’s progress in their personal “Learning Journey” incorporating samples of their work. *

Yes
No

I give consent for members of staff undergoing training, to attain nationally recognised qualifications, to assess and observe my child. *

Yes
No

I give permission for my child to go on supervised outings within Chudleigh. *

Yes
No

I confirm that the above information is correct.

Signature of Parent/Guardian *

Relationship to Child *

Date / Time *

Date

Time