Little Trees Joining Form

Required

GENERAL INFORMATION

Complete this form to let us know all about your child before they start nursery. This form takes approximately 10-15 minutes, so please make sure you have time to complete all the sections.

Please indicate which nursery your child is joiningrequired

Parent's namerequired

First Name

Last Name

Email Addressrequired

Phone numberrequired

Child's namerequired

First Name

Last Name

Child's date of birthrequired

My child is interested in

CHILD WELLBEING

Please state the languages spoken at home.

Please detail your child’s family background.(Please give details on immediate family members, who makes up your family?)

Are any milk feeds to be given to your child during the session? (Please give details on quantity/ times/ temperature/ type etc. Please note formula milk must be provided as well as a bottle and drinking cup)

What stage is your child within the weaning process? (Please provide details of your child’s favourite foods, as well as foods they do not enjoy, including food intolerances)

Does your child sleep during the day? (Please provide the times your child generally goes to sleep and how long for? Where? Bouncer/ cot … Does your child have a comforter?)

What is important to your child? (Please give details from the child’s perspective, on what they like, favourite toys/ games/ songs etc?)

What is important for your child? (Please give details from your perspective. It may be that you prefer to limit the time your child has their dummy?

Anything else that we need to know about your child to fully enable us to care for them?

MEDICAL INFORMATION

Please list the vaccinations you child has received and the date when they were immunised.required

For guidance: https://www.gov.uk/government/publications/routine-childhood-immunisation-schedule

Has your child had the flu vaccination? If so, please provide the date.

Has your child ever had any serious illness or operation? If so, please give particulars and dates.

Does your child wear glasses?

Yes

Does your child have any specific disabilities – emotional, educational or physical?

Does your child take any medication, e.g. for asthma, hayfever, epilepsy etc? If so, please give details.

Does your child have any allergies or follow any special diet?

Please provide the name, address and phone number of your child's doctor.required

Please provide the name, address and phone number of your child's health visitor.

Any other health professional involved, e.g. Speech & Language Therapist? If so, please provide details.

I give consent for staff to administer medication as advised by me the parent/ guardian. I am aware that only prescribed medications are allowed to be administered. I also give consent for medical attention to be obtained if I cannot be contacted, including the administration of temperature relieving medication by the Nursery Manager.

I consent

I do not consent