SECTION 3 PLACES REQUESTED – Please state exactly which early learning and childcare sessions you are enrolling your child to attend.* NURSERY CAMPUS SELECTED: (Please Elgin Fort William Oban Tornagrain tick) LENGTH OF CONTRACT: Term Time Only Year round provision Monday Tuesday Wednesday Thursday Friday 8:30AM-1PM 8:30AM-3:30PM 8.30am-5:30PM 1PM-5:30PM * While the Nursery Team aim to be aware of parents needs and wish to be supportive in meeting their requirements, it will not always be possible to offer the sessions requested. □ □ Is your child on a split nursery placement? Yes No Other nursery provider: What primary school do you intend to enrol your child to? SECTION 4 CHILD HEALTH INFORMATION – Medical Information/Contacts please provide details of any medical condition of which the Nursery Team should – be aware (e.g. asthma, allergies, eyesight, hearing problems, speech therapy, epilepsy etc) Does the child have any medical condition, disability, additional support needs or receive regular medication? □ □ Yes No If yes, please give details Doctor’s Surgery Surgery Telephone Number Surgery Address Professionals currently involved with the child (eg. Social Worker, Health Visitor etc): Do you give Stramash consent to share information on your child to other agencies as required including SALT, Health Visitor, □ □ Yes No Social Worker? Stramash have the to share your child’s information to the appropriate professionals without consent if we are concerned about the welfare of the child. SECTION 5 SUN BLOCK/MIDGE AND ADDITIONAL CONSENTS (please tick yes/no) Yes No – Do you give permission for early years staff to apply sun block/midge repellent to your child if it is deemed necessary? Do you require to provide information relating to religion e.g. observance of religious festivals, prohibited foods? Does your child have any non-medical dietary requirements e.g. vegetarian, no e-numbers? If yes, please give details
SECTION 3 – PLACES REQUESTED Please state exactly which early learning and childcare sessions you are enrolling your child to attend.* NURSERY CAMPUS SELECTED: (Please tick) Elgin Fort William Oban Tornagrain LENGTH OF CONTRACT: Term Time Only Year round provision Monday Tuesday Wednesday Thursday Friday 8:30AM-1PM 8:30AM-3:30PM 8.30am-5:30PM 1PM-5:30PM * While the Nursery Team aim to be aware of parents needs and wish to be supportive in meeting their requirements, it will not always be possible to offer the sessions requested. Is your child on a split nursery placement? Yes □ No □ Other nursery provider: What primary school do you intend to enrol your child to? SECTION 4 – CHILD HEALTH INFORMATION Medical Information/Contacts – please provide details of any medical condition of which the Nursery Team should be aware (e.g. asthma, allergies, eyesight, hearing problems, speech therapy, epilepsy etc) Does the child have any medical condition, disability, additional support needs or receive regular medication? Yes □ No □ If yes, please give details Doctor’s Surgery Surgery Telephone Number Surgery Address Professionals currently involved with the child (eg. Social Worker, Health Visitor etc): Do you give Stramash consent to share information on your child to other agencies as required including SALT, Health Visitor, Social Worker? Yes □ No □ Stramash have the to share your child’s information to the appropriate professionals without consent if we are concerned about the welfare of the child. SECTION 5 – SUN BLOCK/MIDGE AND ADDITIONAL CONSENTS (please tick yes/no) Yes No Do you give permission for early years staff to apply sun block/midge repellent to your child if it is deemed necessary? Do you require to provide information relating to religion e.g. observance of religious festivals, prohibited foods? Does your child have any non-medical dietary requirements e.g. vegetarian, no e-numbers? If yes, please give details