Please fill in the form below to register for Club.

There is a certain amount of information that we must have in advance in order to be able to manage our activities, comply with legislation and offer your child the best care and security.

Information about you only has to be entered once on this page along with details of the first child that you wish to register. Once you have completed this registration you will be able to make bookings online and add other children .

IF YOU ARE ALREADY REGISTERED PLEASE DO NOT REGISTER AGAIN
PLEASE CLICK HERE TO GET AN EMAIL REMINDER
All items marked with an asterisk MUST be filled in please

    Section One - Main Parent/Carer (where child lives)

























    Section Two - Second Parent/Carer















    Address if different from child









    Section Three - Emergency Contact

    Please detail an emergency contact that we are able to ring who can pick up your child in the event that we are unable to get hold of you.



















    B - Information About Your Child

    Section One - Child Information















    Section Two - Things We May Need to Know

    Our role is to ensure the children in our care are safe and happy and to do that it helps if we have as much family and background information as possible. So please use this space to tell us anything you think is necessary ie. adoption/fostering/parents no longer together/parents deceased.

    ALL INFORMATION PROVIDED WILL REMAIN PRIVATE & CONFIDENTIAL

    Section Three - Additional Information

    Please inform us of any additional information we need to be aware of, ie. people who are not authorised to collect the child (please ring office with more details if required):

    Section Four - Medical Information

    Part 1 - Doctor Contact Information





    DOES YOUR CHILD HAVE ANY MEDICAL CONDITIONS? (Please specify)

    Section Five - Allergies and Special Dietry Requirements

    DOES YOUR CHILD HAVE ANY ALLERGIES? (Please specify)

    ACTION TO BE TAKEN?

    DOES YOUR CHILD HAVE ANY DIETRY REQUIREMENTS? (due to religion, family preference, way of life, health status, etc - please specify)

    C - General Information and Confirmations

    Section One - Please Tell Us Where You Heard About Club?

    Your Child's School?Newspaper/Magazine?

    Word of Mouth?Other?

    Section Two - Please Read Carefully and Complete ALL Parts

    I agree that photos/video recordings of my child can be taken for advertising purposes, ie: posters, wall displays, our website, social networking sites such as Facebook / Twitter, newspaper pieces:

    YesNo

    I understand that emergency services may be contacted during the running of the Club if thought appropriate. I understand that the play care staff are authorised to sign any written forms of consent required by the hospital authorities if my child’s life is in danger. I understand that first aid treatment may be carried out on my child by a first aid trained member of staff:

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    I consent for my child to travel on your minibuses (and in the event of a problem with the minibus, with staff in their cars who are insured to carry children) and go off site when this is detailed on the

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    I have read the Club Terms and Conditions and Policies and Procedures and acknowledge that I am bound by these. These are subject to change, but you will be informed if they are. The most current version will be on the website.

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