Register your child with us. - Orchard Lea Nursery and Pre-School

Registering your Child with Orchard Lea Nursery & Preschool

Please complete this form if you wish to register your child to start at our nursery. We advise that you come and have a look around before registering.

- Step 1 of 11

Which nursery & preschool would you like to register with *

Please select the nursery you would like to register you child with.

Child's Full Name

(Registered on birth certificate)

Preferred name

(name used on a daily basis)

Childs Date of Birth *

Please use your estimated due date if your child isn't born yet.

Gender

When would you like your child to start

Please note there is a minimum 4 week registration period. If you are unsure please leave blank.

Days Requiried

Monday
Tuesday
Wednesday
Thursday
Friday

What days would you like your child to attend.

Monday Sessions

Am (morning session)
Pm (Afternoon session)
All day session

Please select which session for Mondays.

Monday Morning Session Times

Breakfast club (07:30 - 08:00)
08:00 - 12:00 (4hrs) - Please note this session is not available for under 2's as they have lunch at 11:45
08:00 - 12:30 (4.5hrs) - Please note this session includes lunch for under 2's only
08:30 - 12:30 (4 hrs) - Please note this session includes lunch for under 2's only
08:00 - 13:30 (5.5hrs including lunch)
08:30 - 13:30 (5hrs including lunch)

Please select what hours you would like your child to attend on Monday mornings. Please note our under 2's have lunch at 11:45am, therefore lunch is included as part of the morning session.

Monday Afternoon Session Times

13:30 - 17:30 (4hrs)
12:30 - 17:30 (5hrs including lunch)* Except under 2's
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Monday afternoons

Monday All Day Session Times

Breakfast club (07:30 - 08:00)
08:00 - 16:00 (8hrs)
08:30 - 16:30 (8hrs)
09:00 - 17:00 (8hrs)
08:00 - 16:30 (8.5hrs)
08:30 - 17:00 (8.5hrs)
09:00 - 17:30 (8.5hrs)
08:00 - 17:00 (9hrs)
08:30 - 17:30 (9hrs)
08:00 - 17:30 (9.5hrs)
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Monday

Tuesday Sessions

Am (morning session)
Pm (Afternoon session)
All day session

Please select which session for Tuesdays.

Tuesday Morning Session Times

Breakfast club (07:30 - 08:00)
08:00 - 12:00 (4hrs) - Please note this session is not available for under 2's as they have lunch at 11:45
08:00 - 12:30 (4.5hrs) - Please note this session includes lunch for under 2's only
08:30 - 12:30 (4 hrs) - Please note this session includes lunch for under 2's only
08:00 - 13:30 (5.5hrs including lunch)
08:30 - 13:30 (5hrs including lunch)

Please select what hours you would like your child to attend on Tuesday mornings. Please note our under 2's have lunch at 11:45am, therefore lunch is included as part of the morning session.

Tuesday Afternoon Session Times

13:30 - 17:30 (4hrs)
12:30 - 17:30 (5hrs including lunch)* except under 2's
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Tuesday afternoons

Tuesday All Day Session Times

Breakfast club (07:30 - 08:00)
08:00 - 16:00 (8hrs)
08:30 - 16:30 (8hrs)
09:00 - 17:00 (8hrs)
08:00 - 16:30 (8.5hrs)
08:30 - 17:00 (8.5hrs)
09:00 - 17:30 (8.5hrs)
08:00 - 17:00 (9hrs)
08:30 - 17:30 (9hrs)
08:00 - 17:30 (9.5hrs)
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Tuesday

Wednesday Sessions

Am (morning session)
Pm (Afternoon session)
All day session

Please select which session for Wednesdays

Wednesday Morning Session Times

Breakfast club (07:30 - 08:00)
08:00 - 12:00 (4hrs) - Please note this session is not available for under 2's as they have lunch at 11:45
08:00 - 12:30 (4.5hrs) - Please note this session includes lunch for under 2's only
08:30 - 12:30 (4 hrs) - Please note this session includes lunch for under 2's only
08:00 - 13:30 (5.5hrs including lunch)
08:30 - 13:30 (5hrs including lunch)

Please select what hours you would like your child to attend on Wednesday mornings. Please note our under 2's have lunch at 11:45am, therefore lunch is included as part of the morning session.

Wednesday Afternoon Session Times

13:30 - 17:30 (4hrs)
12:30 - 17:30 (5hrs including lunch)* except under 2's
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Wednesday afternoons

Wednesday All Day Session Times

Breakfast club (07:30 - 08:00)
08:00 - 16:00 (8hrs)
08:30 - 16:30 (8hrs)
09:00 - 17:00 (8hrs)
08:00 - 16:30 (8.5hrs)
08:30 - 17:00 (8.5hrs)
09:00 - 17:30 (8.5hrs)
08:00 - 17:00 (9hrs)
08:30 - 17:30 (9hrs)
08:00 - 17:30 (9.5hrs)
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Wednesday

Thursday Sessions

Am (morning session)
Pm (Afternoon session)
All day session

Please select which session for Thursdays

Thursday Morning Session Times

Breakfast club (07:30 - 08:00)
08:00 - 12:00 (4hrs) - Please note this session is not available for under 2's as they have lunch at 11:45
08:00 - 12:30 (4.5hrs) - Please note this session includes lunch for under 2's only
08:30 - 12:30 (4 hrs) - Please note this session includes lunch for under 2's only
08:00 - 13:30 (5.5hrs including lunch)
08:30 - 13:30 (5hrs including lunch)

Please select what hours you would like your child to attend on Thursday mornings. Please note our under 2's have lunch at 11:45am, therefore lunch is included as part of the morning session.

Thursday Afternoon Session Times

13:30 - 17:30 (4hrs)
12:30 - 17:30 (5hrs including lunch)* Except under 2's
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Thursday afternoons

Thursday All Day Session Times

Breakfast club (07:30 - 08:00)
08:00 - 16:00 (8hrs)
08:30 - 16:30 (8hrs)
09:00 - 17:00 (8hrs)
08:00 - 16:30 (8.5hrs)
08:30 - 17:00 (8.5hrs)
09:00 - 17:30 (8.5hrs)
08:00 - 17:00 (9hrs)
08:30 - 17:30 (9hrs)
08:00 - 17:30 (9.5hrs)
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Thursday

Friday Sessions

Am (morning session)
Pm (Afternoon session)
All day session

Please select which session for Friday

Friday Morning Session Times

Breakfast club (07:30 - 08:00)
08:00 - 12:00 (4hrs) - Please note this session is not available for under 2's as they have lunch at 11:45
08:00 - 12:30 (4.5hrs) - Please note this session includes lunch for under 2's only
08:30 - 12:30 (4 hrs) - Please note this session includes lunch for under 2's only
08:00 - 13:30 (5.5hrs including lunch)
08:30 - 13:30 (5hrs including lunch)

Please select what hours you would like your child to attend on Friday mornings. Please note our under 2's have lunch at 11:45am, therefore lunch is included as part of the morning session.

Friday Afternoon Session Times

13:30 - 17:30 (4hrs)
12:30 - 17:30 (5hrs including lunch)* Except under 2's
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Friday afternoons

Friday All Day Session Times

Breakfast club (07:30 - 08:00)
08:00 - 16:00 (8hrs)
08:30 - 16:30 (8hrs)
09:00 - 17:00 (8hrs)
08:00 - 16:30 (8.5hrs)
08:30 - 17:00 (8.5hrs)
09:00 - 17:30 (8.5hrs)
08:00 - 17:00 (9hrs)
08:30 - 17:30 (9hrs)
08:00 - 17:30 (9.5hrs)
Tea Club (17:30 - 18:00)

Please select what hours you would like your child to attend on Friday

Main Parent Contact Details

Main contact person, full name & title:

(Who the child normally lives with)

Relationship to child:

Home address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home address of the main contact person.

Personal Email *

(used for parent link login & Invoices)

Mobile Phone:

Home Phone:

Work Phone:

National insurance or NASS number:

Date of Birth

Main Parent DOB

Does this person have full parental responsibility?

Does this person have legal contact?

Main contact employers name:

Employers Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Work Phone:

Work Email:

Second Parent Contact details

Secondary contact person, full name & title:

Relationship to child

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Secondary contact Address

Personal Email

(used for parent link login)

Mobile Phone

Home Phone

National insurance or NASS number:

Date of Birth

Secondary Parent DOB

Does this person have full parental responsibility?

Does this person have legal contact?

Secondary contact employers Name

Work Phone

Employers Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Work Phone:

Work Email:

Other Family Members

Is there anyone else that has full parental responsibility?

This person will also be able to collect from nursery.

Relationship to Child

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Please let us know if your child is subject to any particular care arrangements or court orders. This will help us support you and your family.

Other emergency contact - Name:

Relationship to child

Phone

Number of Siblings

First Sibling Name:

Sibling Date of Birth

Gender

Second Sibling Name:

Sibling Date of Birth

Gender

Third Sibling Name:

Sibling Date of Birth

Gender

Fourth Sibling Name:

Sibling Date of Birth

Gender

Other People within the Household

Is there anyone else that lives with you?

Not including siblings or other people you've listed perviously.

Name

Relationship to child:

Approximate age:

Details of other significant people in your child’s life:

Name

Relationship to child:

Adult or Child?

Details of any other Educational Settings Attended

Does your child currently attend with any other nursery, childminder or preschool etc

Please give details:

Do you give permission for us to contact them to arrange a transfer meeting and set up information sharing?

(This will help us work together in partnership, share your childs progress, and help settle them into nursery sooner)

Has your child attended another nursery, childminder, preschool in the past?

Reason for Leaving:

Do you give permission for us to contact them to arrange a transfer meeting?

(This will help us work together in partnership and share your Childs progress)

Medical History

Does your child have any current or past medical conditions? *

Please give details

We will draw up a health care plan with you up upon starting settling in sessions at nursery.

Does your child take medication regularly? *

Please detail what, amounts, when and why?

We will draw up a health care plan with you up upon starting settling in sessions at nursery.

Was your child born at full term?

How many weeks early were they?

Were there any complications during birth?

Please give details:

Any other admissions to hospital?

Please give details:

Does your child have any distinguishing marks or features, e.g. Mongolian blue spots, birth marks, strawberry marks etc.

Please give details:

Does your child have any dietary intolerances? *

Dietary Requirements due to intolerance:

Additional dietary comments:

Please note nursery meals and snacks form part of a healthy, balanced diet and low sugar & salt options are used. Due to the large amount of dietary requirements we receive, which is becoming increasingly difficult to manage, unless your child has an intolerance, we may not be able to cater for specific needs.

Please list the festivals and events celebrated by you as a family or as part of a community (e.g. religious festivals, cultural events, foods and activities):

Is there anything that you would prefer your child not to do/eat/join in with (e.g. face painting, yoga, Christmas celebrations etc):

Does your child have any special needs/requirements:

The more information you can give us the better we can support your child's need.

Please give details:

Health

NHS Number:

Dr Name

Doctors Surgery Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Health Visitor Name:

Health Visitor Contact Details

Phone number or email address

Dentist Details

Immunisations

2 months

5-in-1 (DTaP/IPV/Hib) vaccine
Pneumococcal (PCV) vaccine
Rotavirus vaccine
Meningitis B

3 months

5-in-1 (DTaP/IPV/Hib) vaccine, 2nd dose
Meningitis C
Rotavirus vaccine, 2nd dose
Meningitis B

4 months

5-in-1 (DTaP/IPV/Hib) vaccine, 3rd dose
Pneumococcal (PCV) vaccine, 2nd dose

Between 12 & 13 months

Hib (4th dose)/Men C (2nd dose) booster (single jab)
Measles, mumps & rubella (MMR) vaccine (single jab)
Pneumococcal (PCV) vaccine, 3rd dose

2, 3 & 4 years

Children’s flu vaccine (annual)

3 years & 4 months, or soon after

Measles, mumps & rubella (MMR) vaccine, 2nd dose
Second Choice4-in-1 (DTap/IPV) pre-school booster (single jab)

Childhood Illnesses

Measles:

Chicken Pox:

Whooping Cough:

Rubella:

Meningitis:

Mumps:

Hand, Foot & Mouth:

Molluscum Contagiosum:

Scarlet Fever:

Scarlatina:

Support

Is there a social worker currently involved with your family?

Name

Contact Phone

Has there been a social worker currently involved with your family in the past

Please give details

Does your child access additional support (e.g. speech therapy/physiotherapy etc) *

The more information you give us the better we can support your child's needs.

Support Role

Support information

Please provide as much information as possible

Name

Contact Number

Is there anything else you would like share or you would like to discuss face to face?

Is there anything that we can do to help you and your child feel more welcome?

Additional Information

The Department of Education and Local Authority have requested that we provide data to enable statical information and monitoring.

Ethnicity

Nationality:

Religion:

First Home Language:

Second Home Language:

Other Languages spoken:

Are there any thing relating to your child’s ethnicity, culture, language, religion etc that you wish us to be aware of?

Permissions

These must be completed and signed by the parent/persons that have parental responsibility for the child.

Prior consent for Emergency Medication and Treatment

If you are happy for us to administer medication/treatment please sign below. Please note we will not administer any medication/treatment which has not been given to the child before. Be reassured that we will continue to contact you for verbal permission before administering emergency medication.

Signature for Permission to administer emergency medication: *

Things like Calpol, Piriton, Ibuprofen etc. We usually always call to advise before administering.

Signature for Permission to administer emergency treatment: *

Simple things like cold compresses and plasters to more advanced things like abdominal thrusts should a child be choking.

Parents consent to liaise with outside agencies (eg. speech therapy/physiotherapy etc) if and when appropriate:

Signature

Prior consent for photographs to be taken

We have to hold written permission on file to be able to take any photographs of your child. Please note that all old photographs are either given to parents or shredded.

Signature for Permission to take photographs for display work within the Nursery:

Signature for Permission to take photographs to contribute towards your child’s online learning journal: (This is an important document which will go home and to school) *

Without this permission we will be unable to record your child's progress via our learning Journal.

Prior consent for photos & video/media to be used publicly.

We love to share some of the things the children get up to at nursery. We do this by sharing either photographs or video footage via our website and social media (E.g. Facebook & Instagram).

If you are happy for your child to take part, please sign below. If not your child will still be included however their face will be blurred or pixelated out of any photos or videos that we post online.

If you would rather your child not be included, we will blur/pixilate their face on any media.

Consent for Nursery Management Software

All family and child details recorded from this registration form are entered onto a Nursery management software called Famle. We use this software to create registers, invoices, and manage children attendances. We also use an App for the children’s learning journals called Famly. Parents will be able to see the information we populate when they download and login to the Famly app.

If you are happy for information to be populated into Famly, please sign below. *

Without this consent we will be unable to register your child.

Prior consent for Sun cream

We require all children to wear sun cream whilst at nursery, to effectively safeguard them from the harmful effects of the sun. Please see your UV protection policy for further information. We use 5 star rated UVA & UVB protection.

Suncream *

I am happy to use Nursery Suncream
I will provide my own suncream

Application Permission signature *

I give my permission for Nursery staff to apply and rub in suncream provided as above to areas of the body that are exposed and are at risk of UV damage.

All about me (Your Child)

It is helpful if you can complete this nearer your child’s start date. We ask for this information to help your child settle with us. It should include things they are interested in, what they like to do, favourite toys, any siblings, how do I drink my drink - trainer cup – with/ without lid, potty training, sleep routine etc). Baby and Toddler sleep routine questionnaires will be given separately. If you prefer we can complete this with you during our home visit, or you can complete it closer to your Childs start date.

From the Parents:

From the child:

From the previous setting/carer/group:

Permission to Collect

Please complete these if you would like someone (other than Parents) to collect your child from nursery.

Will anyone else be collecting your child on a regular basis?

(If so, please complete and return the Permission collect form)

I give permission for:

Name of person

to collect:

Name of child

Relationship to child:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Collection Password

We will require the person collecting to use this password upon their arrival at nursery

Permission Signature

Once completed we will assume the person detailed on this form will have permission to collect on an ongoing/ unrestrictive basis. Please inform us if this changes.

Picture

Click or drag a file to this area to upload.

You can upload a picture of the person collecting if you wish but it is not required.

Do you require another Permission to collect form?

Is it likely another person will be collecting occasionally

I give permission for:

Name of person

to collect:

Name of child

Relationship to child:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Collection Password

We will require the person collecting to use this password upon their arrival at nursery

Permission Signature

Once completed we will assume the person detailed on this form will have permission to collect on an ongoing/ unrestrictive basis. Please inform us if this changes.

Picture

Click or drag a file to this area to upload.

You can upload a picture of the person collecting if you wish but it is not required.

Do you require another Permission to collect form?

Is it likely another person will be collecting occasionally

I give permission for:

Name of person

to collect:

Name of child

Relationship to child:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Collection Password

We will require the person collecting to use this password upon their arrival at nursery

Permission Signature

Once completed we will assume the person detailed on this form will have permission to collect on an ongoing/ unrestrictive basis. Please inform us if this changes.

Picture

Click or drag a file to this area to upload.

You can upload a picture of the person collecting if you wish but it is not required.

Do you require another Permission to collect form?

Is it likely another person will be collecting occasionally

I give permission for:

Name of person

to collect:

Name of child

Relationship to child:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone (copy)

Collection Password

We will require the person collecting to use this password upon their arrival at nursery

Permission Signature

Once completed we will assume the person detailed on this form will have permission to collect on an ongoing/ unrestrictive basis. Please inform us if this changes.

Picture

Click or drag a file to this area to upload.

You can upload a picture of the person collecting if you wish but it is not required.

Terms & Conditions

Agreement to the terms and conditions set out at www.orchardleachildcare.co.uk/terms *

We agree to the terms

Full terms can be viewed at www.orchardleachildcare.co.uk/terms

Parent one Name *

Signature *

Date *

Parent Two Name

Signature

Date

We require a copy of your child's birth certificate or passport

Click or drag a file to this area to upload.

If easier you can upload a picture with your registration form, or email it over to us, or bring it into the office at a later date.

GDPR Agreement *

I consent to Orchard Lea Nursery storing my submitted information so they can register my child.

Additional Comments

Please provide any comment relating to your registration form here.

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