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Sandleford Nursery Registration Form

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Sandleford Nursery Registration Form

Date of Entry (e.g. May 2019)*

Child’s Information

Full Name (as on birth certificate)* Name Known By (if different)

Gender*MaleFemale

Date of Birth / Due Date* Nationality* Religion* Address 1* Address 2 Town* Postcode* First Language* Second Language (if applicable)

Parent Information

Parent 1 Full Name* Address (if different from child’s) Home Telephone Number Work Telephone Number Mobile Telephone Number* Email* Parent 1 Occupation Parent 2 Full Name* Address (if different from child’s) Home Telephone Number Work Telephone Number Mobile Telephone Number* Email* Parent 2 Occupation

Do both parents have parental responsibility for the applicant? (If no, please give further details below)*YesNo

If you answered (No) please provide more details below.*

Emergency Contact Information (in absence of parents)

Name* Relationship to Child* Address* Home Telephone Number* Work Telephone Number Mobile Telephone Number* Email*

Sessions Required

Full Day 7.30am—6.30pmMondayTuesdayWednesdayThursdayFriday

Morning Only 7.30am—12.30pmMondayTuesdayWednesdayThursdayFriday

Afternoon Only 11.30am—6.30pmMondayTuesdayWednesdayThursdayFriday

Please indicate if you require*Full Time (50 weeks a year)Term Time Only

Do you wish to reserve a place in Reception*YesNo

Previous Childcare or Education

Current Childcare or Education Date of Entry Address Person in Charge Telephone Number Where did you hear about St Gabriel’s?*

Medical Information

Doctor* Telephone Number* Surgery Address*

Has your child had the following vaccinations:DiphtheriaWhooping CoughTetanusPolioMMRHIBMeningitis

Has your child had any of the following? (Please tick all that apply)Asthma or bronchitisAllergies to any known medicationHeart conditionAny other allergies (fabric, food, nuts, plasters etc)Fits, fainting or blackoutsOther conditions/illnessSevere headachesTravel sicknessDiabetesRegular medicationIs your child receiving medical or surgical treatment of any kind from either the family doctor or a hospital?Has your child been given specific medical advice to follow in emergencies?Does your child have any specific dietary requirements (non-dairy, vegetarian, no pork)?If it is considered necessary, do you agree to mild pain killers (e.g. paracetamol or Calpol) or antihistamines (e.g. Piriton) being administered?

Ethnicity (Please tick as appropriate)*WBRI White, BritishWIRI White, IrishWIRT Traveller of Irish HeritageWROM Gypsy/RomaWOTH White, any other White BackgroundMWBC Mixed, White and Black CaribbeanWBA Mixed, White and Black AfricanMWAS Mixed, White and AsianMOTH Mixed, any other mixed backgroundAIND Asian or Asian British, IndianAPKN Asian or Asian British, PakistaniABAN Asian or Asian British, BangladeshiAOTH Asian or Asian British, any other Asian BackgroundBCRB Black or Black British, CaribbeanBAFR Black or Black British AfricanBOTH Black or Black British, any other Black BackgroundCHNE ChineseOOTH Any other Ethnic BackgroundREFU Did not wish to be recorded

Disclosures

Please tick below if any of the following circumstances apply to this application:The child has any known medical condition or health problemThe parents are separated or divorcedThere are any Court Orders in relation to the childThere are any Court Orders in relation to either parentThe child may be unable to play a full part in the sporting curriculum of the nurseryThe child has been dismissed or removed from a school for misconduct

Further Information

Notes

· Registration does not commit Sandleford or the parents to an offer of a place
· Offers of places are made subject to availability
· Early registration is recommended: registrations are considered in the order received
· Parents should read the accompanying standard Terms & Conditions before signing
· Registration is subject to a non returnable fee of £75.00
· The registration fee may be paid by debit card over the phone or by bank transfer, using your child's name as your reference. Account Name: St Gabriel's School Foundation. Account Number: 65326369. Sort Code: 60-15-07. Bank: NatWest, Market Place, Newbury
· A copy of the birth certificate or the biometric page of the applicant’s passport will be emailed to admissions@stgabriels.co.uk

Parent Declaration

I / we the parents / guardians of*

request that she/he be registered as a prospective pupil of St Gabriel’s. We understand that the standard Terms & Conditions will undergo reasonable changes from time to time as circumstances require, and will apply in all our dealings with the school.

Agreed by*Parent 1Parent 2

Sandleford Nursery Registration Form
Sandleford Nursery Registration Form
Junior, Senior & Sixth Form Registration Form

Sandleford Priory Newbury Berkshire RG20 9BD

01635 555680

info@stgabriels.co.uk

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