Registration Form 2016/17

CHILDCARE REGISTRATION FORM 2016/17 This form must be fully completed for each child before you can access Tomnacross Primary School Childcare Services. This will provide a wide range of information necessary to care for your child. Please complete and return it to the School. Please note completion of this form does not guarantee you a place. Bookings are taken on a first come first served basis. CHILD DETAILS Full name: Preferred name/nickname: Date of birth: Class: Nursery P1 P2 P3 P4 P5 P6 P7 Teacher/Early Years Practitioner name: Doctor’s Name & Surgery: Please list any additional needs, medical conditions or allergies we should know about: Please list any medication that the child may have to self administer: Any special dietary requirements: Any other useful information Headteacher: Alison Donald Tomnacross Primary School, Kiltarlity, Inverness-shire IV4 7HW Tel - 01463 741497 E-Mail: [email protected] PARENT/CARER INFORMATION Parent/Carers names: Home Address: Postcode: Home telephone number: Mobile numbers: Work numbers: Place of Work: Email: IMPORTANT PERMISSIONS Please read the statements below and give your consent or not. If you have any queries regarding these, please don’t hesitate to ask a member of staff. I have been informed of the childcare service Policies and Operating YES NO Procedures and I am aware I can access these at anytime. I give permission for the club to provide Boots Soltan Kids suncare cream YES NO for my child during outdoor activities in warm weather. I give permission for photos to be taken of my child at the club, which may YES NO occasionally be used in publicity for the club. My child can participate in activities which may involve wearing face-paints, YES NO temporary coloured hairsprays, transfers or tattoos. I authorise staff to give any necessary first aid treatment to my child, YES NO accompany my child to the hospital in my absence. Headteacher: Alison Donald Tomnacross Primary School, Kiltarlity, Inverness-shire IV4 7HW Tel - 01463 741497 E-Mail: [email protected] CONTACT INFORMATION Please provide two emergency contacts who we can contact if we are unable to reach you - do not include yourself as one of these contacts. Emergency Contact 1 Name: Relationship to child: Home Number: Mobile Number: Work Number: (including extension number) Emergency Contact 2 Name: Relationship to child: Home Number: Mobile Number: Work Number: (including extension number) Please ensure you update us on any changes of telephone numbers given above. COLLECTION ARRANGEMENTS Please list responsible adults who are permitted to collect the named child: Name Relationship to child Contact number Children will not be passed on to the care of an adult if they are not named above. The Childcare Service must be kept informed of any changes to collection arrangements. Signed ………………………………………………………… Parent/Carer Date ………………………………………………………….. Headteacher: Alison Donald Tomnacross Primary School, Kiltarlity, Inverness-shire IV4 7HW Tel - 01463 741497 E-Mail: [email protected] CHILDCARE PAYMENTS Bookings Please find enclosed a new booking sheet for completion and return as soon as possible. If you will be changing your requirements on a regular basis due to changing work patterns, please indicate this clearly on the form and we will issue you with a new booking form after 4 weeks. Alternatively you can complete the annual booking section for the whole session. Please note you will have to give 48 hours notice of any change to your requirements otherwise the full fee will be charged. Payments There are various options available for payment of childcare fees. They are as follows: - Direct debit – sign up for direct debit and we will give you statement at the end of the month of how much your fees are. We will work out how much the fees will be for the session and we will take the same amount out of your account over 10 months (September to June). Childcare Vouchers – If you are in receipt of childcare vouchers from your employer then these can be used in full or part payment of the monthly invoice. Please provide the relevant details of your scheme to ensure that we are set up to accept them. Monthly Invoice – WAYS TO PAY YOUR MONTHLY INVOICE In person - at one of our Service Points Internet – Log on to www.highland.gov.uk 24 hours a day, 7 days a week and go to Online Payments Telephone –By telephone to a member of Council staff - Telephone the payment line on 0845 6024232 and a member of staff will be able to take your payment. This service is available Monday-Friday 8am to 6pm, and Saturday 9am to 12 noon. By Bank Credit Transfer/Telebanking - Please pay to the relevant sort code and bank account number from your Council bill, and please remember always to include your full Council reference number. At Post Offices, Paypoint or Payzone Outlets Simply give your bar coded Council bill or “swipe card” to the staff at any Post Office, PayPoint or Payzone outlet. Tell them how much you wish to pay. You will be given a receipt, which you should keep as a record of your payment. Headteacher: Alison Donald Tomnacross Primary School, Kiltarlity, Inverness-shire IV4 7HW Tel - 01463 741497 E-Mail: [email protected] Please return this section with your registration form NAME OF CHILD: CLASS: I would like to undertake the following option for payment of my childcare costs. Please tick 1) Direct Debit Equal payment over 12 months (September to August) 2) Monthly Invoice 3) Childcare Vouchers Name of Childcare Voucher Provider ………………………………………………………………………………… Please complete and return to Tomnacross Primary School Office Parents Name Parents Signature Date Headteacher: Alison Donald Tomnacross Primary School, Kiltarlity, Inverness-shire IV4 7HW Tel - 01463 741497 E-Mail: [email protected] .

Load more