Registration Form - Barry


Kidsstop Logo

 

Child Details

Child’s name
Name to be used at Kidsstop
Date of Birth
School Class / Year

 

Gender
Ethnicity
Religion
Language(s) spoken

 

Address

 

Please state who has Parental responsibility for your child/Who has legal access to your child? (at home & away from the home).Is anyone else involved in the care of your child?

 

Parent(s)/ Carer(s) Information

Person 1

First Name
Address
Home Telephone Number
Work Telephone Number
Mobile Number

 

Person 2

First Name
Address
Home Telephone Number
Work Telephone Number
Mobile Number

 

Emergency Contacts Details Please provide 3 contacts in case of emergency

Person 1

Name
Place & hours of work

 

Person 2

Name
Place & hours of work

 

Person 3

Name
Place & hours of work

 

Names of any other persons authorised to pick up your child. (Please give contact numbers/passwords to be used or any relevant or important information)

 

Child’s Welfare

Child’s Doctor
Address
Telephone Numbers
Does your Child have any Allergies or Dietary Requirements?

If Yes, please specify in as much detail as possible:

 

Please state any significant preferences, dislikes & religious requirements.

 

Please state whether your child has a disability or requires extra support. Please indicate how we can help & support your child.

 

Record of immunisations.

 

Please indicate if you consent to a member of staff to help apply sun screen if needed. (I will supply sunscreen clearly labelled with my child’s name.)

Please indicate if you consent for a plaster to be applied if needed.

 

Any other relevant information

Sessions

Breakfast

A session is from 8am-9am & costs £3.50 per session.

After School Club

A session is from 3.25pm-6pm & costs £9.50 per session.

Holiday club- Open 8am-6pm

(Various sessions are available)

 

Please state days required: Please state preferred start date:

Please note that if your child is unable to attend for any reason a refund is not available. This is to allow us as a small business to cover all costs incurred. You must inform the KidsStop Manager of any absences to safeguard your child. You will not be charged for Bank Holidays. Snow Days-If Kidsstop is open you will be charged. If it is closed you will be charged half fees. Fees MUST be paid a month in advance and by the 1ST of every month. A charge will be applied for late payment at a rate of £5 per day. Consistently late fees may result in your child’s place being terminated at KidsStop. One months’ notice is required if you wish to terminate your place at KidsStop. The termination period must be paid whether your child attends or not. A place is not reserved until a deposit/fees are paid in full. A late charge applies at a rate of £5 per every 15 minutes you are late picking up your child.

 

Contact Details 

Barry Primary School
Barry Road
Northampton
NN15 5JS

Tel: 01604 234576
Mobile: 07769515958
Email: nikki@kidsstop.co.uk

Ofsted Registration EY481252

 

By signing this document, I confirm that all the information is accurate & up to date. I will inform the manager immediately of any changes.
Signed on:

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Signature Certificate
Document name: Registration Form - Barry
Unique Document ID: 04280fe9db3ed822c55294bf17b312c01868f838
Timestamp Audit
5th October 2017 9:51 pm GMTRegistration Form - Barry Uploaded by Nikki Sexton - contracts@kidsstop.co.uk IP 92.12.103.176