Registration Form (SV) | Kiddies Kottage Nursery School

Home
Streatham
Addiscombe
Know Us
Our Curriculum
Keeping You in the Loop
Work With Us

Registration

Note: Only United Kingdom residents are eligible

Child's Details

Child's First name *

Child's Surname *

Gender *MaleFemale

Date of Birth *

Ethnic Origin *

Languages Spoken *

Religion *

Which of the parents/carers below does the child normally live with? *

Parent or Carer's Details

Parent or Carer 1

First Name *

Surname *

Date of Birth *

Relationship to Child *

Occupation *

Home Address *

City *

ZIP / Postal code *

Home Phone *

Mobile Phone *

Email Address *

Work Address *

City *

ZIP / Postal code *

Office Phone *

Email Address *

Does the person have legal “parental responsibility” for the child? *YesNo

Parent or Carer 2

First Name *

Surname *

Date of Birth *

Relationship to Child *

Occupation *

Home Address *

City *

ZIP / Postal code *

Home Phone *

Mobile Phone *

Email Address *

Work Address *

City *

Office Phone *

Email Address *

Does the person have legal “parental responsibility” for the child? *YesNo

Alternative Emergency Contact

Emergency Contact 1

First Name *

Surname *

Relationship to Child *

Mobile No. *

Collection password (if child is to be collected by someone not known to the nursery

Emergency Contact 2

First Name *

Surname *

Relationship to Child *

Mobile No. *

Collection password (if child is to be collected by someone not known to the nursery)

Health Information

Child's Doctor

Full Name *

Street Address *

City *

ZIP / Postal code *

Phone *

Child's Health Visitor

Full Name *

Street Address *

City *

ZIP / Postal code *

Phone *

Allergies and dietary requirements

Does your child have any allergies? *YesNo

If so, please give full details below *

Does your child have any dietary requirements that are not due to allergies? *YesNo

If so, please give full details below *

If you answered YES to either of the above questions, is the exposure to the allergen or failure to comply with the dietary requirement likely to result in serious harm to your child’s health as far as you are aware?YesNo

Note

If this information changes in the future, please notify the nursery immediately on a “Change to Allergy or Dietary Requirements” form. Please give us as much detail as possible, including specific ingredients.

Medication requirements

Does your child have any regular medication? *YesNo

If so, please give full details below *

Other information

Does your child have siblings? *YesNo

If so, please give full details below *

Does your child known to the Social Services? *YesNo

If so, please give full details below *

Does your child have any special educational needs or disabilities? *YesNo

If so, please give full details below *

Has your child been referred to a specialist for support or disabilities? *YesNo

If so, please give full details below *

Authorisations

Emergency Medical Treatment

In the event of an emergency, the nursery staff will take your child to a doctor or to the hospital treatment or call an ambulance.

If you do not consent to this, please speak to the Nursery Manager before completing this form so that alternative arrangements can be explored.

Do you give permission for the nursery staff to seek emergency medical advice and/or treatment for your child? *YesNo

Nappy Cream

We supply Sudocrem ™ and staff members will apply this if and when they feel that it is needed.If you would prefer that we do not apply nappy cream to your child, please tick the "NO" box.

Do you give permission for the nursery staff to apply nappy cream to your child if needed? *YesNo

Sun Cream

Iwe require your authorisation in order to be able to apply sun cream to your child.We supply sun cream and staff members will apply this if and when they feel that it is needed. If you do not consent to this, please speak to the Nursery Manager so that alternative arrangements can be made.

Do you give permission for the nursery staff to apply sun cream to your child if needed? *YesNo

Outings that do not require Motorised Transport

From time to time, the nursery will take the children out on walks to visit shops, the library, the park and other local attractions. Appropriate staff ratios will be maintained at all times and procedures are in place to manage and reduce risks.

Do you give permission for your child to be taken on outings that do not involve the use of motorised transport? *YesNo

Photographs (Internal Use)

We take photographs and short videos of children participating in learning activities to be used in displays around the nursery and in the children's development records.

Do you give permission for photographs and videos to be taken of your child and used for the purposes described? *YesNo

Photographs (External Use)

Iwe take photographs and short videos of children participating in learning activities and share these with current and potential new parents on the nursery's described? Facebook page, website, newsletter etc.

Photographs may also appear in other printed electronic media accessible to the public (e.g. local newspapers) in connection with the nursery's marketing efforts.

Do you give permission for photographs and videos to be taken of your child and used for the purposes described? *YesNo

Booking Request

Preferred start date *

Please detail the session that you would like to book *

Important Notice*

Please bring your child’s red book, birth certificate and proof of address at the time of registration

Consent *

Yes, I agree with the terms and conditions and that:

1. This application form has been correctly completed to the best of your knowledge.
2. You have read and thereby agree to abide by the terms and conditions detailed above.
3. You agree that you are jointly and severally liable to pay the nursery's fees in accordance with the payment terms above.

Follow
Follow
Follow
Follow

Home Streatham Addiscombe Know Us Our Curriculum Keeping You in the Loop Work With Us

2026 © All Rights Reserved

Privacy Policy | Terms of Use