Family Name:

MaleFemale

First Name:

Age in months/years:—Please choose an option—0 Months1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months1 Year2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10 Years11 Years

Full Name:

Relationship to Child:

Email:

Contact Telephone Number:

Full Name:

Relationship to Child:

Email:

Contact Telephone Number:

Full Name:

Relationship to Child:

Email:

Contact Telephone Number:

Does the child have any special dietary needs?

YesNo

If Yes, please give details:

Does the child have any allergies or medical conditions?

YesNo

If Yes, please give details:

Do you give permission for your child’s photo to be taken for promotional purposes on our website and social media including those of other parents?

YesNo

I confirm, to the best of my/our knowledge, the information given in this form is correct, and I/we understand and accept all terms stated below.

Parent/Guardian Name (1):

Relationship to Child:

Sign below:

Parent/Guardian Name (2):

Relationship to Child:

Sign below:

COVID secure – keeping us all safe

If you/your child has any COVID symptoms, or has been in contact with anyone showing symptoms please DO NOT ATTEND the club. Please use the hand sanitisers provided and ensure you wash your hands regularly. Your details above provide us with information required for NHS track and trace. Grown-ups - Please adhere to social distancing at all times and wear a face covering indoors unless exempt.

Waiver

We accept no responsibility for your child whilst at the session – parents must ensure that they supervise their child at all times.

Sickness Policy

We follow NHS advice on children’s sickness. Children who are unwell should not attend the baby group.

Data Protection Policy (GDPR)

We are required to hold and use personal data requested in order to comply with the statutory framework of England, Ofsted, the Department for Education and the local authority early years team. Your data will not be disclosed to any other parties and will be kept securely.