APPLICATION FORM FOR REGISTRATION
         Please fill the registration form in block capitals:
          Forenames:                                           Known as:
          Surname:                                             Home address:
          Date of Birth:                                       Town: 
          Gender:                                              Postcode:
         CHILD'S DETAILS
         PLACES REQUIRED 
         The proposed start date will be the first official day in the Nursery which is important to us so we can 
         contact you prior to arrange settles and invoice you correctly. Please tick the required boxes, two full days 
         minimum. If booking two full days only, these days must be Friday and Monday.
          
         PROPOSED START DATE:  
         Monday                     Tuesday               Wednesday               Thursday                  Friday
         PARENT / CARER DETAILS 
         Relationship:                 Title:             Forename:                        Surname:
         Address:
         Postcode:                                                         Contact Tel No:
         Daytime Tel No:                                                   Mobile No:
         Email address:                                                    Occupation: 
         Place of work:                                                    Work Tel No: 
         Relationship                  Title              Forename                         Surname
         Address
         Postcode                                                    Contact Tel No
         Daytime Tel No                                              Mobile No
         Email address:                                              Occupation 
         Place of work:                                              Work Tel No:
         FAMILY PASSWORD
         We operate a family password system, in the instance of the usual person not being able to collect the child this 
         password will be asked for.  Parents/ guardians MUST advise the Nursery prior to the new person collecting the child. 
         Otherwise, the child will not be allowed to leave the premises.  This password must remain confidential to the 
         family/ designated people responsible for collecting the child.
         Please indicate your password
                           EMERGENCY AND MEDICAL
         EMERGENCY CONTACTS MUST NOT BE PARENTS/CARERS
         Parents and Carers will always be contacted first from both their telephone number and work number, and if we cannot reach any 
         parents or carers, then the emergency contacts will be used. 
         Relationship:                 Title:              Forename:                         Surname:
         Address:                                                            Contact Tel No:
         Postcode:                                                           Mobile No:
         Occupation:                                                         Work No: 
         Email address:                                                      Daytime Tel No:
         Relationship:                 Title:              Forename:                         Surname:
         Address:                                                            Contact Tel No:
         Postcode:                                                           Mobile No:
         Occupation:                                                         Work No:
         Email address:                                                      Daytime Tel No:
         MEDICAL TREATMENT CONSENT
         Should your child become unwell whilst at St Margaret's Nursery, we require your consent to treat them.
         I do            I do not         give an employee trained in first aid consent to treat my child.
         I do            I do not         give a doctor or other medical professional consent to treat my child.
         If your child develops a temperature over 37.5C, we have a duty of care to inform you and ask for permission to 
         administer emergency Calpol. If we cannot contact, you and receive verbal consent to administer emergency 
         Calpol at the appropriate dosage do you give St Margaret's Nursery permission to administer emergency Calpol. 
         I do            I do not         give consent for St Margaret's Nursery to administer an emergency dosage of Calpol 
         if your child temperature reaches over 37.5C. 
         If we do get consent to administer emergency Calpol the child must be collected as soon as possible. If the 
         temperature continues to increase, then we reserve the right to call an ambulance. 
         I understand that St Margaret's Nursery will contact me immediately in the event of a medical professional treating 
         your child. 
         Parent’s signature:      _______________________________________                   Date:   _______________________
         MEDICATION CONSENT
         Please tick below to state you agree to the following:
                 I will inform the Nursery of my child being given any medicines prior to attending on the day of Nursery.
                 I give consent for a member of St Margarets Nursery to apply sun cream (supplied by Nursery). 
                 I give my consent for my child to participate in the tooth brushing programme.
                 I will inform and update the Nursery of any known allergies, dietary requirements, medical conditions, or 
         changes to my child's health and well-being. 
         Parent’s signature:      _______________________________________                   Date:   _______________________
                                 CHILDRENS BACKGROUND
             CHILD'S HEALTH INFORMATION
             Doctor's Details
             Medical Practice & Doctors name:                                                      Any allergies/dietary requirements your child has:
             Health Visitor/Named person name & contact details:                                   Any medical conditions or additional support for learning 
                                                                                                   your child has/needs that we should be aware of: for 
                                                                                                   example Relux, Asthma, Autism, Spina bifida.
             ETHNIC BACKGROUND
             Please tick only one of the following categories, and this information will be kept strictly confidential in line with the new 
             legislation. 
                          African/British/Scottish                                Caribbean or Black Caribbean/                                White Gypsy Traveller
                                                                                  Caribbean/ British/ Scottish      
                          African – Other                                         The Caribbean or Black - Other                               White – Irish
                          Asian – Bangladeshi/ British/                           Mixed or multiple origins                                    White –Other
                          Scottish                         
                          Asian – Chinese/ British/                               Not Disclosed                                                White –Other British
                          Scottish                         
                          Asian – Indian/ British/                                Not known                                                    White –Polish
                          Scottish                         
                          Asian – Other                                           Other - Arab                                                 White –Scottish
                                      
                          Asian – Pakistani/ British/                             Other - Other                                    If other, please provide details
                          Scottish                        
             RELIGION
             Please tick any religious affiliation below.
                          Buddhist                                                Sikh                                                         Not Disclosed
                                                                                              
                          Christian                                               Jewish                                                       Not Known
                          Christian RC                                            Muslim                                                       Other
                          Hindu                                                   None                                             If other, please provide details
             NATIONAL IDENTITY 
             Please tick ONE category below
                          British                                                 Not Disclosed                                                Scottish
                                                                                              
                          English                                                 Not known                                                    Welsh
                          Northern Irish                                          Other                                            If other, please provide details
                                PERMISSION / CONSENT
         PHOTOGRAPHIC CONSENT
         I do             I do not        give permission for us to take photographs/ videos of your child to be used within 
                                          the nursery setting.
         I do             I do not        give permission for us to take photographs/ videos of your child to be used on 
                                          our nursery website – www.stmnursery.com 
         I do             I do not        give permission for us to take photographs/ videos of your child to be used on 
                                          our social media platforms. Facebook, Instagram, Twitter, Pinterest etc.  
         Please note, inspectors require evidence of the activities we offer the children in our care.  Photographs may be used 
         in the Nursery in the normal publicity of good work/ a positive nursery ethos.
         The photographs St Margaret's Nursery take will be uploaded on to 'Online Learning Journals', as this is a third-party 
         website it may take up five working days for your child's profile to be live. You will be notified by the email you have 
         provided us to set up your own username and password for security. This is not used to watch your child live; it is a 
         platform to document your child's milestones and development throughout their sufficient time at St Margaret's 
         Nursery. The senior of your child's room will be able to help you with any queries with regards to the online learning 
         journals. 
         Parent’s signature:      _______________________________________                   Date:    _______________________
         OUTINGS/ TRIPS CONSENT
         I do             I do not        give my consent for my child to be taken on local walks.
         I do             I do not        give my consent for my child to be taken on local public transport.
         I do             I do not        give my consent for my child to be taken in the nursery minibus. 
         I do             I do not        give consent for a member of St Margaret's Nursery to apply sun cream
         We reserve to the right to take the children out in all weathers as we advise parents/carers to bring appropriate 
         clothing. The children have the right to access outdoor play during any time at St Margaret's Nursery. Please see the 
         document 'My World Outdoors' and 'Out to Play' which highlights the importance of outdoor play which was issued 
         by the Care Inspectorate. 
         Parent’s signature:      _______________________________________                   Date:    _______________________
         HEALTHY LIVING 
         At St Margaret's Nursery, our menus change all the time, keeping our food Organic, fresh and interesting for 
         everyone. Children at St Margaret's come from lots of different cultures so the food we serve reflects this. Our menu 
         has been created in line with 'Setting the Table' and 'Food Matters' documents. We do not add any salt or sugar in 
         our meals. Due to our allergies and medical conditions policy we do not accept any foods that are brought from 
         home as this may cause harm and threat to life to other children which have allergies, medical conditions, 
         intolerances, culture preferences and dietary requirements. Please make sure you do not leave any unwanted food in
         any of your child's belongings, such as bags or pockets. 
         Parent’s signature:      _______________________________________                   Date:    _______________________
                                TERMS AND CONDITIONS –