Data Collection

This form is designed to help us provide the best care for your child, please complete this form as fully as possible. Please note this information is help under the General Data Protection Regulation for use with preschool and services related to your child’s education only.

CHILD’S DETAILS

Legal Name Of Child *

First

Middle

Last

Preferred Name Of Child

First

Last

Date of Birth *

Gender *

Address *

Postcode *

Start Date *

What type of contract do you require?

3-4 year old FEL 15

Working Parent Entitlement 15 / 30 hours code

2 Year Funding for Families claiming certain benefits code

Please select the required days, 1 day minimum requirement.

Monday *

None
7.30-9.00 breakfast club (£9.35)
9-4 (FEL /WPE) funded session (3-4 year olds & 2 year olds claiming benefits) (£9.10)
9-4 WPE funded session (2 year olds) (£15)
4-5.30 tea club (£9.35)
7.30-5.30 full day (£64.40)

Tuesday *

None
7.30-9.00 breakfast club (£9.35)
9-4 (FEL /WPE) funded session (3-4 year olds & 2 year olds claiming benefits) (£9.10)
9-4 WPE funded session (2 year olds) (£15)
4-5.30 tea club (£9.35)
7.30-5.30 full day (£64.40)

Wednesday *

None
7.30-9.00 breakfast club (£9.35)
9-4 (FEL /WPE) funded session (3-4 year olds & 2 year olds claiming benefits) (£9.10)
9-4 WPE funded session (2 year olds) (£15)
4-5.30 tea club (£9.35)
7.30-5.30 full day (£64.40)

Thursday *

None
7.30-9.00 breakfast club (£9.35)
9-4 (FEL /WPE) funded session (3-4 year olds & 2 year olds claiming benefits) (£9.10)
9-4 WPE funded session (2 year olds) (£15)
4-5.30 tea club (£9.35)
7.30-5.30 full day (£64.40)

Friday *

None
7.30-9.00 breakfast club (£9.35)
9-4 (FEL /WPE) funded session (3-4 year olds & 2 year olds claiming benefits) (£9.10)
9-4 WPE funded session (2 year olds) (£15)
4-5.30 tea club (£9.35)
7.30-5.30 full day (£64.40)

Lunch (£3.50 per day) - would you like your child to provided with lunch for the term *

Charges summary:

£65 admin fee including waterproof suit and login to tapestry
£64.40 – full day 7.30-5.30 3/4 year old
£64.40 – full day 7.30-5.30 2 year old FEL/WPE hours 9am-4pm term time only
£9.35 - Breakfast Club 7.30am-9.00am
£9.35 Tea Club 4pm-5.30pm
£9.10 sustainability fee (added to invoice for each FEL/EFEL session)
£15 sustainability fee for WPE 2 year olds / £3.50 lunch per day (optional, term minimum)
£10 additional session you book if on a term time contract and you book additional sessions during the holidays at preschool
£8.50 per hour if you need to book a few hours adhoc on a day your child does not normally attend between 9am-4pm, subject to availability (optional, booking through email)

Will your child be attending another setting? *

If so, which?

How many hours are claimed at their other setting eg FEL15/WPE 15/30

Can we get in touch to share information eg assessments, next steps?

PARENT'S / CARERS

Please give details of all persons who have parental responsibility and anyone else who you wish to be contacted in an emergency in priority order. Text messages and emails go to the priority 1 contact.

Priority 1 - Name

Priority 1 - Relationship

Priority 1 - Address

Priority 1 - Phone Number, Mobile & Work Phone

Priority 1 - Email *

Form confirmation will be sent here

Priority 1 - National Insurance Number

Priority 1 - Date of Birth

Priority 2 - Name

Priority 2 - Relationship

Priority 2 - Address

Priority 2 - Phone Number, Mobile & Work Phone

Priority 2 - National Insurance Number

Priority 2 - Date of Birth

Who else lives in your house? Please inclued Name/Age/Relationship to child

Absent Parent Information

Every parent has the right to receive information regarding their child’s education and progress in preschool. If your child has a parent that does not normally live with them please provide their details so we can keep them informed of open events, your child’s reports and photos.

Name:

Address

Telephone

EMERGENCY CONTACTS

Emergency Contact 1 - Name

Emergency Contact 1 - Relationship

Emergency Contact 1 - Address

Emergency Contact 1 - Phone

Emergency Contact 1 - Mobile

Emergency Contact 1 - Work Phone

Emergency Contact 2 - Name

Emergency Contact 2 - Relationship

Emergency Contact 2 - Address

Emergency Contact 2 - Phone

Emergency Contact 2 - Mobile

Emergency Contact 2 - Work Phone

MEDICAL INFORMATION

Details are kept on all ongoing or temporary medical needs. Please keep us to do date with this information as it helps our first aiders support your child.

Red book up to date?

Details are kept on all ongoing or temporary medical needs. Please keep us to do date with this information as it helps our first aiders support your child.

Immunisations up to date?

Details are kept on all ongoing or temporary medical needs. Please keep us to do date with this information as it helps our first aiders support your child.

2 year review completed?

Details are kept on all ongoing or temporary medical needs. Please keep us to do date with this information as it helps our first aiders support your child.

2 Year Review comments

Medical Practice

Address

Telephone

Medical Conditions (including allergies/asthmas/diabetes):

Is there a care plan for your child?

Does your child currently receive any treatment from the following professionals?

Occupational Health
Physiotherapy
Speech Therapy

Does you child have any hearing/visual problems?

If your child needs to be given medication during preschool hours please ensure a medical request form is completed.

In an emergency a qualified first aider will give first aid eg clean and dress a wound, provide bandages, call emergency services and administer CPR if required. Can your child receive a blood transfusion if required?

Please provide information for any dietary requirements eg Halal, Vegan

Ethnicity:

First or Home Language:

Country of Birth:

Nationality:

COLLECTION FROM FORESTEERS OUTDOOR PRESCHOOL

All children must be collected by 5.30. Only parents can authorise another adult to collect their child and they must be over 16 years old. They must provide the password to collect the child.

I give the following adults permission to collect my child:

The password is:

I understand that no other adult will be able to collect my child and agree to inform preschool if this information changes.

At Foresteers Outdoor Preschool we like to take photos and videos of the children being engaged in their learning. We use photos as evidence for their learning journeys and to celebrate achievement. We may also display some photos in the setting, on the Foresteers website and on social media sites such as facebook and twitter. Occasionally we may have be visited by the media who would like to take photos or film footage of an event that could appear on local or national newspapers or programs.