Kids Play Childcare Registration Form

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Registration Form

OFSTED requires a Childcare booking should be fully registered.
Please answer all the details below.

or if you would prefer, click the PDF icon
and download a printable copy.

Please select the centre required?

Parents/Guardian Details

Title:
First Name:
Last Name:
Email Address:
Marital Status:
Ethnic Group:
Religion:
Home Address:
Postcode:
Home Telephone No:	inc. STD
Mobile No:
Employers Name Address:
Postcode:
Work Telephone:	inc. STD
G.P.’s Name:
Surgery Name:
Surgery Address:
Postcode:
Surgery Telephone:	inc. STD

Child/Children’s Details:

Child 1
Childs First Name:
Childs Last Name:
Childs Date of Birth:	DD/MM/YY
Gender:
Childs Address if different from Parent/Guardian (Please just tick if the address of the Child is the same as the Parent/Guardian)	Same as Parent/Guardian
Childs School:
School Address:
School Postcode:
School Tel:	inc. STD
Childs Ethnic Group:
First Language:
Other:
Special Requirements: (e.g access, dietary)
Any Illnesses or Allergies:
Medication (if any):
Care Plan in Place:

If you are only registering 1 child please click here to move to the next section

Child 2
Childs First Name:
Childs Last Name:
Childs Date of Birth:	DD/MM/YY
Gender:
Childs Address if different from Parent/Guardian (Please just tick if the address of the Child is the same as the Parent/Guardian)	Same as Parent/Guardian
Childs School:
School Address:
School Postcode:
School Tel:	inc. STD
Childs Ethnic Group:
First Language:
Other:
Special Requirements: (e.g access, dietary)
Any Illnesses or Allergies:
Medication (if any):
Care Plan in Place:

If you are only registering 2 children please click here to move to the next section

Child 3
Childs First Name:
Childs Last Name:
Childs Date of Birth:	DD/MM/YY
Gender:
Childs Address if different from Parent/Guardian (Please just tick if the address of the Child is the same as the Parent/Guardian)	Same as Parent/Guardian
Childs School:
School Address:
School Postcode:
School Tel:	inc. STD
Childs Ethnic Group:
First Language:
Other:
Special Requirements: (e.g access, dietary)
Any Illnesses or Allergies:
Medication (if any):
Care Plan in Place:

Emergency Contacts/Collections:

Emergency Contact 1
Full Name:
Address:
Postcode:
Home Tel:	inc. STD
Mobile:
Work Tel:	inc. STD
Relationship to Child:

Emergency Contacts/Collections:

Emergency Contact 2
Full Name:
Address:
Postcode:
Home Tel:	inc. STD
Mobile:
Work Tel:	inc. STD
Relationship to Child:

Emergency Contacts/Collections:

Emergency Contact 3
Full Name:
Address:
Postcode:
Home Tel:	inc. STD
Mobile:
Work Tel:	inc. STD
Relationship to Child:

Person with parental Responsibility

Name:
Telephone:	inc. STD
Relationship to Child:
Name:
Telephone:	inc. STD
Relationship to Child:
Name:
Telephone:	inc. STD
Relationship to Child:

Permission Form:

Emergency Medical Attention:

Yes - I give permission for my child(ren) to be taken to the nearest hospital for necessary emergency treatment in the event that I cannot be contacted.

No - I do not give permission for my child(ren) to be taken to the nearest hospital for necessary emergency treatment in the event that I cannot be contacted.

Signed:
Date:	DD/MM/YY

Activities and Outings:

Yes - I give permission for my child(ren) to go on outings and to participate in activities organised by Kids Play. This includes permission for the use of transport in vehicles such as people carriers and mini-buses.

No - I do not give permission for my child(ren) to go on outings and to participate in activities organised by Kids Play. This includes permission for the use of transport in vehicles such as people carriers and minibuses.

Signed:
Date:	DD/MM/YY

Photographs:

Yes - I give permission for my child(ren) to be photographed for display purposes within Kids Play.

No - I do not give permission for my child(ren) to be photographed for display purposes within Kids Play.

Signed:
Date:	DD/MM/YY

Plasters:

Yes - I give permission for my child(ren) to use plasters when needed.

No - I do not give permission for my child(ren) to use plasters when needed.

Signed:
Date:	DD/MM/YY

Sun Cream:

Yes - I give permission for my child(ren) to use sun cream when needed.

No - I do not give permission for my child(ren) to use sun cream when needed.

Signed:
Date:	DD/MM/YY

Permission for Transportation:

Kids Play use transportation such as people carriers and mini-buses to transport children from school and on outings. If you wish NOT to give permission for transport then other arrangements may be made.

Yes - I give permission for transportation.

No - I give permission for my child(ren) to walk with Kids Play staff to or from school.

Signed:
Date:	DD/MM/YY

Permission for Television:

Yes - I give permission for my child(ren) to watch U and PG rated DVDs and television programmes.

No - I do not give permission for my child(ren) to watch U and PG rated DVDs and television programmes.

Signed:
Date:	DD/MM/YY

Permission for Observation:

Due to the new E.Y.F.S. standard we now have to carry out observations on all children under 6 years old to monitor ther progress.

Yes - I give permission for my child(ren) to be observed.

No - I do not give permission for my child(ren) to be observed.

Signed:
Date:	DD/MM/YY

I/We parents of
Child 1	DOB	DD/MM/YY
Child 2	DOB	DD/MM/YY
Child 3	DOB	DD/MM/YY
Residing at:

Signed:	Date:	DD/MM/YY

Please tick to confirm you have read Kids Play Childcare
terms and conditions.

If you have not read them please click here

Please copy the letters you see below into the box before
submitting your registration form
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Bury | Kettering | Leighton Buzzard | Milton Keynes

Registered Office: Kids Play Limited. Station Hill, Bury St. Edmunds, Suffolk IP32 6AD.
Telephone: Tel: 01284 763799 Email: sharonelliott@kidsplaychildcare.co.uk