New starter information form

Once you have been offered a place you must fill in this form before their child can start nursery school.

At which school does your child have a place?*Church HillLow Hall

About your child

Child's first name* Child's surname* Child's date of birth* Select your child's ethnicity* Religion in family, or none, or leave blank:

Health

Doctor's name/GP Practice name: GP's address: GP's Post code: GP's phone number: Health visitor's name: Health visitor's phone number: Date of last tetanus injection: Date of latest development check: 2 year old check/last check with HV/GP: Does your child have any particular health considerations? Please give details and any special requirements or reasonable adjustments the school needs to make to support the child’s needs, e.g. EpiPen, inhaler. Does your child have any non-food allergies? e.g. penicillin, plasters, anaesthetic, wasp stings/insect bites? Please provide a doctor’s note with details.

If your child develops a particular health need while at our school, please talk to their Key Person about it so we can support them.

Dietary requirements

Does your child have any food allergies? If yes, what are they:

Select one of the following:*eats meat (note: all meat served in school is halal)vegetarianveganother

If 'other' please give details:

Emergency contact details

Please tell us at least one person we can contact in an emergency if we are unable to contact you.

1. Name: Phone number: Alternative phone number: Address: Relationship to child: 2. Name: Phone number: Alternative phone number: Address: Relationship to child:

Other people whom you permit to collect your child

1. Name: Relationship to child: If they have a disability, are there any reasonable adjustments we can make to welcome them?

Note: you are disabled under the Equality Act 2010 if you have a physical or mental impairment that has a substantial and long-term (12 months or more) negative effect on your ability to do normal daily activities.

2. Name Relationship to child: If they have a disability, are there any reasonable adjustments we can make to welcome them?

Person/people not authorised to collect or have access to your child

1. Name: 2. Name Context, e.g. injunction number:

Consent and communication

Your email address, so that you can be sent a copy of your answers:

Please let us know as soon as possible if any of the information you have given us on this or any other form changes.

Please confirm your consent:*I consent to the Forest Alliance of Nursery Schools storing the information I have provided here in accordance with their Privacy Policy and using it to take care of my child and send me information about the schools.