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Daisy Chain Registration Form

We strongly advise you to visit our nursery before enrolling as this will allow you to understand better who we look after children in our care, as well as see our facilities.

However if you wish to access our registration form before visiting us, please print out the attached -


DAISY CHAIN NURSERY REGISTRATION FORM


Child's Full Name

 

DOB

M/F

 

Parents/Guardian

 

 

 

Home Address

 

 

 

 

 

 

 

 

Home Tel. No.

 

 

 

Work Tel. No.

 

 

 

Work Addresses

 

 

 

 

 

 

 

 

 

 

 


Emergency Contacts:

(When parents not available)


Name

 

 

Relationship

 

 

Tel. No.

 

 

Name(s) of person(s)

to collect child

 

 

Relationship(s)

 

 

Tel. Nos.

 

 

 

Child’s Doctor

 

Address

 

Tel. No.

 

 

Health Visitor

 

Dentist

Allergies

 

 

Medicine/ emergency treatment authorisation

 


I herebycertify that I have read and agree to the terms and conditions of registration.


Parent’/Guardians

Dated

 

Signatures

 

Dated