Thank you for considering Puddle Ducks Nursery for your child’s early years education. Please complete the form below to register your child with us.
Child’s Full Name*
Date of Birth*
Gender*
MaleFemale
Home Address*
Primary Language(s) Spoken at Home*
Full Name*
Relationship to Child*
MotherFatherGuardian Other:
Phone Number*
Email Address*
Alternative Contact Number
Address (if different from child)
Do you have parental responsibility?*
YesNo
Full Name
Relationship to Child
Phone Number
Email Address
Do you have parental responsibility?
Name
Can we contact this person in case of emergency if parents/guardians are unavailable?
Yes
Special Password for Collection
(we’ll ask for this password if your child is being picked up by someone new)
Does your child have any medical conditions?* YesNo
If yes please specify:
Does your child have any allergies or dietary requirements?* YesNo
Doctor’s Name
Doctor’s Address
Doctor’s Phone Number
Does your child have any special educational needs, disabilities, or other support requirements?* YesNo
If yes, please specify:
Please tell us about your child’s routine, interests, personality, and anything important to help us care for them:*
Does your child have a preferred comfort item/s?* YesNo
If yes, please give a brief description of their comfort item:
Preferred start date*:
Morning session 8am-1pm
Afternoon session 1pm-6pm
Monday
Tuesday
Wednesday
Thursday
Friday
*** If you are applying for 30 hour funding this is equal to 22.5 hours stretched as we are operating 51 weeks per year. ***If you are applying for 15 hours funding this is equal to 11.25 hours stretched as we are operating 51 weeks per year. We are very happy to offer any support needed in your funding application. Also, please speak to us about how we can accommodate all hours of your funding.
Are you planning to apply for funding?* YesNo
15 hours (11.25 hours stretched)30 hours (22.5 hours stretched)
We use the secure online platform Tapestry to document and share your child’s learning journey through photos and observations. Photos are used solely for educational and communication purposes.
Do you give permission for us to take photos of your child to be used on the Tapestry app?* YesNo
Do you give permission for your child’s photo to appear in group observations on Tapestry (shared with other parents)?* YesNo
Are we permitted to apply Sudocrem or similar creams to your child if needed?* YesNo
Are we permitted to supply our own sun cream if you have not supplied an alternative?* YesNo
Are we permitted to take your child on local nature walks or visits to the farm animals that are not on the main nursery site?* YesNo
Please sign to confirm the information given is correct to the best of your knowledge. By signing and registering I understand the personal information given here and on other submitted forms will be stored in accordance with the nursery’s GDPR policy, a copy of which can be made available on request.
Please sign to confirm I have read and agreed to all policies and procedures. Please note these policies are subject to change and the latest versions will always be available on our website.
I give permission for staff, particularly those trained in first aid, to administer basic first aid to my child, including the use of plasters, antiseptic wipes, and other appropriate supplies. I also authorise the nursery to seek emergency medical assistance, including contacting the emergency services or taking my child to a hospital, if deemed necessary by a trained first aider or other qualified staff member.
Parent/Guardian 1
Print Name*
Date*
Parent/Guardian 2
Print Name
Date
