Admission Form

Your Child

Child's Name

Date of Birth

Day

Month

Year

Ethnic Origin

NHS number

Multi-line address

Country/Region

Address

City

Zip / Postal code

If your child lives at any other addresses, please give details below

Parents/Carers

1. Parent/Carer's Name

2. Parent/Carer's Name

Relationship to Child

Contact Number

Place of Work and Address

Emergency Contact Details

Please provide the name, daytime address and telephone number of at least 3 other adults that we can contact in an emergency.

1. Name

2. Name

3. Name

Phone

Address

A collection password is mandatory. Please provide one even if you don’t intend for anyone else to collect your child, other than their named parent/carer, in case of emergency.

Please detail here if any person/s do NOT have legal access to your child

Permissions and Consent

Outings

Do you give permission for the pre-school to take your child on short outings, in the local area, in small groups with appropriate adult support?

I give permission

I do not give permission

Your permission will be sought, by separate letter, for outings involving travel/transport.

Application of Suncream at Pre-school

At St Michael’s Pre-school we have a duty of care to protect our children from the harmful effects of sun damage, whilst in our care. We have a sun safe accreditation in association with Skin (www.sunsafenurseries.co.uk). This helps us to ensure all children and parents are taught the basic elements of sun safety. As you may be aware, UV rays are harmful to our skin. Even when the sun is not out, the UV ray level may still be high enough (3 and above) that sun cream should be worn. Therefore, on these days, we ask that parents apply sun cream to their child before attending pre-school. We make available additional/spare sunscreen for all outdoor activities. If you would like to provide your own sunscreen for 'top ups,' please provide a named bottle which can be stored in our sun cream box.

Do you give permission for staff to apply sun cream to my child?

I give permission

I do not give permission

This will be Pre-school sun cream unless a named bottle is provided by parents/carers.

Intimate Care

Toileting and changing will take place in a designated changing area/toilets with one member of staff. The door will not be fully closed, and adults will inform other members of staff. Your child will be given a verbal explanation prior to any physical contact.

Do you give permission for staff to provide appropriate intimate care to your child?

I give permission

I do not give permission

Intimate care includes help with clothing, physical positioning on the toilet, physical help with aiming for boys, bottom wiping, other (e.g. nappy changing routine)

We are happy to apply nappy cream with consent, however we do not provide this. Nappy creams should be labelled and given to a member of staff.

Do you give permission for staff to apply nappy cream at nappy changes?

I give permission and understand that I need to provide nappy cream for my child

I do not give permission

Not applicable

Comforting may include cuddling, sitting on lap, picking up after a fall or accident, checking for injuries (sometimes in an intimate area).

Do you give permission for staff to provide appropriate comfort to your child?

I give permission

I do not give permission

I understand that intimate care will generally be carried out by my child’s key person but may also be carried out by another member of staff.

Tapestry

St Michael's Pre-school use the Online Learning Journal, Tapestry, in the setting. Tapestry allows us to record observations for your children, attach photos and videos, track children’s development and progress and allows you to view live invoices. If you give permission, parents/carers will be set up with their own individual account using the email addresses provided on this form. When your child starts at St Michael's, you will receive an email asking you to activate your Tapestry account and create a password/pin. You can use either the browser version of Tapestry (tapestryjournal.com) or the app. Your email is directly linked to your child's Tapestry account, meaning you will only be able to see observations that include your child. Tapestry securely stores all the data we input to our account on their servers. If you would like further information about how Tapestry keeps your data safe and secure, please go to https://tapestry.info/security.html.

Do you give permission for a Tapestry account to be created for your child?

I give permission

I do not give permission

Photos/Digital Images

During your child’s time at St Michael’s Pre-school images may be taken of your child for our use, to record observations or special events. There may also be occasions where a third party, e.g. other parents or the media, may take images of your child. Images could be a photograph, video/DVD or website image. We may also share images on social media. It is a requirement of the General Data Protection Regulation (GDPR) and Data Protection Act 2018 that we have your consent for this. Your permission is sought in advance to take, display, and on occasion, publish photographs and video recordings involving your child. It is intended that your consent will cover the duration of the time your child attends the setting, however, we will inform you of all instances where images will be published outside of the setting, and you have the right to withdraw consent at any point.

The setting has adopted certain safeguards to minimise any risk to your child:

We will avoid the publication of your child’s full name with any image used by the setting
Images will be kept securely and destroyed after their required time
Staff, volunteers, and parents will not use personal equipment such as mobile phones or cameras to take images of children who attend the setting.

Please note that the setting does not have control of how images taken by the media are published. However, the setting will not provide children’s names to the media without parental permission.

Do you give permission for digital images of your child to be taken and used in the setting; this includes wall displays and or allergy board?

I give permission

I do not give permission

Do you give permission for digital images of your child to be taken and used in group photos on Tapestry learning journals. These may be visible to other St Michael's Pre-school parents/carers on the Tapestry app.

I give permission

I do not give permission

Do you give permission for digital images of your child to be taken and used by the setting for social media; this includes our Facebook page?

I give permission

I do not give permission

Do you give permission for digital images of your child to be taken and used by the setting for our website?

I give permission

I do not give permission

Do you give permission for digital images of your child to be taken and used by third parties; this includes local newspapers and promotional/marketing photos or videos e.g. our Prospectus?

I give permission

I do not give permission

Special Educational Needs and Disability (SEND)

Does your child have any special educational need or disability (SEND) (e.g. medical/physical/behavioural condition such as sight impairment, delayed speech or allergy)?

If Yes to the above, please provide further details

Is your child receiving SEND support from any of the following

Please tick any that apply

Does your child have or is in the process of applying for any of the following

An Education, Health and Care Plan (EHCP)

High Needs Funding (HNF)

Common Assessment Framework (CAF)

Early Support Plan (ES)

Individual Assessment of Early Learning and Development (IAELD)

None of the above

Please tick any that apply

I consent to share any documentation or reports relating to my child’s special educational need or disability and give St Michael's Pre-school permission to contact professionals involved with my child so that they can best meet my child’s individual needs.

Information Sharing

Does your child currently or plan to attend another childcare setting?

If Yes, please provide details below

The Early Years Foundation Stage (EYFS) requires that the pre-school share information with other professionals that work with your child. This helps to ensure that their needs are met and supports their learning and development.

I consent to St Michael's Pre-school contacting my child's other setting to obtain learning and development information to provide for smooth transitions.

When the time comes for your child to leave us, we use various strategies to make this transition smooth. We may share information concerning your child’s progress linked to the EYFS Early Years Outcomes with their new setting. Information about your child’s interests and abilities will enable their new key person to help them settle in quickly.

I understand and give consent for information about my child to be shared with my child’s new setting or school at transition.

Additional Information

Please let us know if your child has any nicknames, comforters, particular fears/phobias, or provide any other information that would be handy for their key person to know

We welcome the opportunity to share cultures, occupations and different experiences and would be grateful if you could provide us with the occupations within your family (e.g. daddy is a cleaner, mummy is firefighter, uncle Jim is a sports coach)

It is important to share and represent diverse cultures and languages in children’s home life at pre-school. Please let us know if you observe any religious/cultural festivals/celebrations or speak any other languages at home

We value that not all households look the same and represent these in our setting. Who lives with your child at home?

Medical Information

Doctor's Name

Surgery Address

Surgery Contact Number

Was your child born before 36 weeks gestation?

Yes

Has your child received the full immunisation program as recommended by your GP?

Yes

If No, please provide details below

Please give details of any relevant medical history, existing conditions, allergies, dietary requirements & medication. Please note – before staff can administer medication, they MUST have written permission from you.

Condition/Diagnosed by/Symptoms/Treatment

I give permission for staff at pre-school to use adhesive plasters if necessary on my child

I give permission for emergency treatment to be carried out should the need arise and contact cannot be made with a parent/carer.

Signature

Signature field is empty.

I have informed the pre-school of any medical conditions or allergies that my child has. I am aware that any allergies will be posted on the staff notice board, along with my child’s name and photograph, to ensure my child’s safety whilst they are at the Pre-school.