Registration Form

If you would like to register your child/children to PiXieS Nursery then please fill out the form below and a member of our staff will get in touch with you shortly.

Child's Details

Full Name:

Religion:

Surname:

Date of Birth: *

Other Names:

Start Date: **

Sex:

MaleFemaleUnborn

* Please enter expected DOB if child is unborn.

** Please enter requested or expected start date.

Preferred Sessions

Parents/Guardians

Carer 1 Details:

Carer 2 Details:

First Name:

Surname:

Relationship to Child:

Home Address (child's home address):

Home Address (if different):

No & Road:

Area:

City:

County:

Post Code:

Phone:

Mobile 1:

Mobile 2:

Email:

Day time (work) contact details:

Day time (work) contact details if different:

No & Road:

Area:

City:

County:

Post Code:

Phone:

Mobile 1:

Mobile 2:

Email:

Are there any other Adults who may collect your child from the nursery?

If so please complete the details below and attach signed photograph(s) for each adult.

First Name:

Surname:

Relationship to Child:

Home Address (child's home address):

Home Address (if different):

No & Road:

Area:

City:

County:

Post Code:

Phone:

Mobile 1:

Mobile 2:

Email:

Medical Information

Doctors Details:

Health Visitors Details:

Name:

No & Road:

Area:

City:

County:

Post Code:

Phone:

Immunisations

Has your child had any of the following immunisations?

1st Diptheria, Tetanus, Whooping Cough, Polio, Hib, Meningitis C

2nd Diptheria, Tetanus, Whooping Cough, Polio, Hib,Meningitis C

3rd Diptheria, Tetanus, Whooping Cough, Polio, Hib, Meningitis C

1st Measles, Mumps, Rubella (MMR)

2nd Measles, Mumps, Rubella (MMR)

Does your child have a medical condition (Allergies, Medication, On going Illness etc.)?

If yes please provide details of their medical condition.

In the unlikely event that a medical emergency occurs it may become necessary for us to obtain emergency medical advice for your child. In serious cases it may be that we would need to obtain emergency treatment.

I/We do give my/our consent for to make arrangements for emergency medical advice or treatment should the occasion arise for the child.

Fees

Fees are payable monthly in advance in accordance with your contracted attendance as above and are due upon receipt of invoice, unless paid by Direct Debit. It is perhaps necessary to point out occasionally there are 5 weeks in a month. The Nursery is closed during National Holidays and fees are not charged for these days. Any other absence will be charged at published discount rate. The Nursery does not allow session "swaps" extra days are charged in arrears.

If payment is not received on time, interest will be added at 2{dbea84a7e92f1898a7662d05ce1e5387782337bef7214b334d485d84fd0c47eb} per day, starting at the first day of the invoice month.

Illness - Should your child become ill at nursery, we will make every effort to contact you and may result in immediate collection of your child. Medication cannot be administered without prior written consent which must be provided together with the medication on the day you require it to be administered.

Meals - We provide a mid morning snack, cooked lunch and a light tea. We do not provide breakfast or any packet/tinned baby food. It is not our policy to give breakfast to your children unless you have booked an early session, and provided their breakfast.

Cancellations - Should you wish to cancel your childs registration please advise us 5 weeks in advance, alternatively we reserve the right to charge one additional full months fees (4 or 5 weeks as appropriate) following the month of your childs indicated start date, or date leaving nursery, which ever is the later, should this notice not be given.

Nursery Opening Times - Morning 07:30 - 13:00, Afternoon 13:00 - 18:00. All day 07:30 - 18:00, School day 09:00 - 15:00. A small extra charge will be made for earlier or later sessions if so requested above.

Unauthorised late collections will be charged at the rate of £28.08 per half hour or part thereof.

For security reasons we will not allow your child to be taken from the premises by anybody other than the adult bringing him / her to Nursery, unless we have written consent to do so, as recorded on the previous page.

Any other information about your child you think we should know?

How Did You Hear About Us

I do not wish to recieve invoices by email

I wish for my details to be passed onto third parties, affiliated sites or businesses

I do not wish to recieve news and information by email.

Please check all questions are answered to avoid registration delays

By ticking this box I/We agree to accept all the nursery terms and conditions. All terms and conditions published.

If you would like to read our Policy before submitting your registration application please click here.

PiXieS Nurseries

Registration

Parents Area