Name………………………………………………………………………………………………………………. Any Other Agency Details i.e. 11. Address……………………………………………………………………………………………………………. Speech Therapist Postcode……………………………………….Telephone No……………………………………………. Date of any 12. injections/immunisations already received by your child. Please give details of any allergies or disabilities or procedures 13. prohibited for Medical, religious or other reasons. Names and ages of any brothers or 14. sisters. Diet Full day children will be provided with a two course lunch. We provide a healthy balanced diet and encourage children to eat a variety of foods. ALL children are provided with a mid morning snack and afternoon tea. A menu is published each week and displayed on the Notice Board. PLEASE INDICATE IF YOUR CHILD SHOULD NOT BE GIVEN CERTAIN FOOD/DRINKS ON THE FOLLOWING GROUNDS (If these are not applicable please leave blank) 15. Medical – My child has a food/drink allergy (Please detail cause and reaction) Religious – The following food/drink should not be given to my child on religious grounds (please give details) Is there anything else, which you think we should know about your 16. child? If ‘Yes’ please give details Does your child have any additional 17. needs? (Provide extra sheet if necessary) What Primary School will your child 18. be attending? (If Known) If your child will be attending 19. another setting please give details here
11. Any Other Agency Details i.e. Speech Therapist Name………………………………………………………………………………………………………………. Address……………………………………………………………………………………………………………. Postcode……………………………………….Telephone No……………………………………………. 12. Date of any injections/immunisations already received by your child. 13. Please give details of any allergies or disabilities or procedures prohibited for Medical, religious or other reasons. 14. Names and ages of any brothers or sisters. 15. Diet Full day children will be provided with a two course lunch. We provide a healthy balanced diet and encourage children to eat a variety of foods. ALL children are provided with a mid morning snack and afternoon tea. A menu is published each week and displayed on the Notice Board. PLEASE INDICATE IF YOUR CHILD SHOULD NOT BE GIVEN CERTAIN FOOD/DRINKS ON THE FOLLOWING GROUNDS (If these are not applicable please leave blank) Medical – My child has a food/drink allergy (Please detail cause and reaction) Religious – The following food/drink should not be given to my child on religious grounds (please give details) 16. Is there anything else, which you think we should know about your child? If ‘Yes’ please give details 17. Does your child have any additional needs? (Provide extra sheet if necessary) 18. What Primary School will your child be attending? (If Known) 19. If your child will be attending another setting please give details here
ENROLMENT-FORM-SEPT-2017.docx