Shining Stars Playschool Blaby Registration Form
Childs Details
Full Name: _________________ Known as _________________
Gender: Male/Female
Date of Birth ___/___/____
Ethnic Origin: _________ Religion: __________ First Language: _________
Home Address : ____________________________ ______________
SECOND ADDRESS: (For example if care is shared with another parent/carer/guardian
outside of the aforementioned address; please advise us of this overleaf). This is only
required if for over 50% of the week.
Telephone: ______________________________ Postcode: ____________
Parents/Guardians Details
*it is a statutory requirement that we obtain information about who has legal contact with
your child and who has parental responsibility. Please see the relative advice within for
further explanation.
Mother/Guardian's Full Name: _________________________________________
Home Address(If different from child) __________________________________
Work phone number: __________________ Mobile: _______________________
Legal Contact: YES / NO
Parental Responsibility: YES / NO
Father/ Guardian's full name: _________________________________________
Home address(If different from child) __________________________________
Work phone number: __________________ Mobile: _______________________
Legal Contact: YES / NO Parental Responsibility: YES / NO
* Where ‘Legal Contact’ or ‘Parental Responsibility’ is “no”, PLease provide an explanation
overleaf.
Session’s Required
MOnday
Tuesday
Wednesday
Thursday
Friday
AM / PM
Full Day
9am - 3pm
AM
9am-12am
AM / PM
Full Day
9am - 3pm
AM
9am - 12pm
AM / PM
Full Day
9am - 3pm
Please see Nursery Prospectus for fee structure and funding details.
Preferred Start date: ____________
Additional Contact Information
Please provide us with two additional contact numbers for persons that, with your
permission may collect your child from the playschool.
The person's identity may be also be contacted in the event of an emergency if we have
been unsuccessful in contacting parents.
First Contact
Name: _____________________ Relationship to Child ____________________
Home/Work Phone number: ________________ Mobile: _____________________
Second Contact
Name: _____________________ Relationship to Child ____________________
Home/Work Phone number: ________________ Mobile: _____________________
Health advice
Doctor's Name ___________________ Surgery Name: ____________________
Surgery Address ________________________________________________
Surgery Telephone: ___________________
Health Visitor name: ________________ Health Visitor Telephone: ______________
It would help us to find out why you choose Shining Stars PLayschool Blaby?
_________________________________________________
Where did you see us advertised? __________________________
Acknowledgement and contract.
I have read, understood and agree to the terms and conditions as attached.
I have signed both copies of the terms and conditions and have returned one copy to the
preschool.
Signature: ___________________________ Date. __________________
For playschool use only
Date Registration received: ______________
Permission form sent, (date) ____________ Received(date): _____________
Learning Journey welcome sent (date): __________ Received (date): _________
Permissions Advice
Local Outings
I give permission for my child to participate in spontaneous local outings, without prior
consent. (Such outings may include a walk to the park, visiting the local library etc.) This
statement only refers to outings within walking distance. Outings requiring Hired/Public
transport will be subject to additional permission/consent.
YES / NO
Parent/guardian signature: _________ Please print: ___________ Date: _______
Sun-cream
I have provided a named bottle of sunscreen for my child and give permission for this to be
applied by playschool staff whenever it is deemed necessary. I confirm that the sun Cream is within expiry and of a high-protection.
Parent/guardian signature: _________ Please print: ___________ Date: _______
Emergency First Aid
In the event of an emergency i give permission for my child to receive emergency first aid
by a trained member of the playschool staff.
YES / NO
In the event of an emergency I give permission for my child to receive emergency medical
treatment or advice in my absence?
YES / NO
In the event of my childs temperature rising above 37.5 degrees, i give permission for
paracetamol ​
(*)​
as provided by myself, to be given according to manufacturer's guidance, i
understand that practical efforts will be made to lower the temperature prior to any
medication being administered. I understand that if my child is deemed to be unwell i will
have to collect them from the playschool. The playschool may only administer paracetamol ​
(*)
provided by the parent guardian
YES / NO
(*) medicine name, (paracetamol brand; ie Calpol): ______________________(please
state product details)
Parent/Guardian Signature____________ Print: ___________ Date: __________
Photographs
I give permission for my child to to be photographed for the purpose of nursery displays
and learning journeys
YES / NO
Parent/Guardian Signature____________ Print: ___________ Date: __________
I give permission for my childs photographs to be used for promotional purposes: to include
our website gallery.
YES / NO
Parent/Guardian Signature____________ Print: ___________ Date: __________
Health
Does your child have a medical condition, learning disability or special educational need?
YES / NO
if yes please provide relative advice. (continue overleaf as required)
Immunisations
Have you ever refused any immunisations for your child?
YES / NO
If yes please provide relative advice. (continue overleaf as necessary)
Allergies
Does your child have any Allergies?
YES / NO
If yes please provide relative advice. (continue overleaf as necessary)
Infectious Illnesses
Has your child suffered from any infectious diseases (for example, impetigo, chicken pox,
measles etc.)
YES / NO
If yes please provide relative advice. (continue overleaf as necessary)
Dietary requirements
Please provide detail of any dietary needs
___________________________________________________________
Additional Information
Does your child attend another provider/childcare setting? YES / NO
If so please provide details to help us work in conjunction with other practitioners.
Does your child (or their siblings) receive any support from social care, (local authority)
YES / NO
If yes please provide details overleaf
Does your Child receive any support in regarding their health other than their GP
YES / NO
If yes please provide details overleaf
Face Paints
During times of celebration we may use face paints with the children.
I give/ do not give permission for my child to have their face painted; ​
Delete as appropriate.
I understand that by providing this consent no other authority is required.
Parent/Guardian Signature____________ Print: ___________ Date: __________
The playschool operates alongside comprehensive policies and procedures
collated in consideration of good practice and the ‘statutory framework for the
early years foundation stage’.
These policies and procedures are available both physically and digitally upon
request. It is recommended that parents read these policies and procedures;
particularly in consideration of safeguarding children please see the play
school's management team.
Please provide a E-Mail: _________________________________
We will use this to keep you updated regarding any playschool news.
I would like to receive correspondence via hard copy as well as digitally via
E-Mail.
YES / NO
Terms and Conditions
The following terms and conditions are part of your registration agreement.
PLayschool operation and administration
The playschool is open Monday 9am - 3pm Tuesday 9am - 12am Wednesday 9am - 3pm Thursday 9am - 12am Friday 9am 3pm, and provides care from 2 through 5 years. All children must be registered with the playschool prior to attendance. Full
time places will be given preference. The playschool is open during local school terms 38 weeks a year. Session fees are not
charged during planned closures. Session swaps are not allowed on a casual basis. The playschool is obliged to obtain
information about who has legal contact and parental contact.
Medication, illness, absence and emergencies
Medication is only administered with written consent from parents. Shining Stars Playschool Management reserves the right
to refuse administration to a child considered ‘Unfit’ to attend. Management reserves the right to refuse administration of
medication. Exclusion periods will depend on advice provided by the ‘Health protection agency’ please request the
associated policy for further details. it is essential that the playschool is provided with accurate details to allow staff to
contact parents in the event of an emergency . The nursery requires written consent to send a child into hospital in an
emergency. Please inform the playgroup if your child is going to be absent.
Special educational needs
Before starting at the playschool parents are asked to provide detailed information regarding any special need your child
may have in order for us to provide accurate care. The play school's SENCO will observe the policy whilst assessing and
coordinating support. Parents raising a complaint should do so via the complaints procedure, (please request appropriate
relative procedure)
safeguarding
The playschool operates a comprehensive policy in relation to safeguarding children. This policy is available upon request
either physically or digitally. It is strongly recommended that all parents familiarise themselves with the aforementioned
procedure.
Equal Opportunities
The playschool pro-actively operates alongside equality. Registration of children and recruitment of staff will be without
prejudice or discrimination of any kind. please request the appropriate policy.
Policies and procedures
All policies and procedures and working practices are in accordance too with the statutory Framework from the Early years
foundation stage. (department for education) please see the Shining stars management team if you would like to receive any
organisational material.
Non Attendance
Refund of fee payments cannot be given in respects of sickness, holidays or play school closures due to circumstances
beyond our control; or in exceptional circumstances.
Notice to terminate or alter sessions
4 weeks notice must be given in writing to alter nursery sessions or to terminate your child's place. This is not required for
increasing number of sessions(subject to availability)
Fee’s and Payments
Fee’s are calculated on a monthly basis and are strictly due for payment on the first working day of the month. Fee’s are
reviewed annually, usually in September. 4 weeks notice will be provided for fee increases. Standing order is the preferred
method of Fee payment. Cash is accepted by Shining Stars Playschool Blaby Ltd. Failure to pay play school fees in full by the
end of the month, will result in the childcare contract being terminated, and 4 weeks payment still due.
Arrival and collection
Children must be handed to a member of staff upon arrival, and never left to enter the playschool alone. Arrival and
departure times are strictly recorded on registers. Only parents/guardians and authorised child collectors will be permitted
to collect a child from the playschool. A late collection charge is £5 per 5 minutes will apply for unarranged care.
Playschool Education Funding
If your child is entitled to playschool education funding, you will be asked to sign a ‘statement of undertaking’ to confirm the
hours that will be accessed. Failing to attend the hours agreed will result in Leicestershire county council recouping the
monetary value of any loss. it is the responsibility of the playschool staff to enquire after any absences or lateness.
Out of hours contact/emergency
Whilst every effort is made to respond to contact made out of hours, please be advised this is not obligatory. please make
contact via the work Mobile 07970072436 or via Email on the Shining Stars Blaby Website.
Complaints Procedures
Complaints should be made to the playschool management team, (or assistant management in their absence) either verbally
or in writing. The management team (or assistant management team) will endeavour to deal with you concern effectively in
accordance with our complaints policy, all matters will be dealt with professionally, promptly and in the strictest of
confidence. Should you be dissatisfied with the response/actions taken you may elect to contact Ofsted. Please be advised of
the contact details; Ofsted, The national Business Unit, Piccadilly Gate, Store street, Manchester M1 2WD. Telephone
03001231231 or by E-Mailing Them @ [email protected]