<p> Buckles & Bows Pre-School Nursery Ongar Hill Addlestone Surrey KT15 1BP Tel: 01932 827556 E-mail: [email protected] </p><p>Childs Full Name: Mobile Number:</p><p>Sex: M F Home Number:</p><p>D.O.B: Email Address:</p><p>Address:</p><p>Nationality: Religion:</p><p>Home Language: Languages spoken By child:</p><p>Does your child have any special educational needs/disabilities? NO YES (please give details, including support received i.e. speech therapist, occupational therapist or other)</p><p>Does your child have any specific dietary requirements including allergies or preferences (i.e. gluten or dairy free, vegan or vegetarian?)</p><p>Does your child have any medical requirements? (i.e. inhaler, epipen)</p><p>* I/We wish to guarantee a place at Buckles & Bows Pre-School Nursery and enclose £50.</p><p>Buckles & Bows Pre-School Nursery Registered Charity No. 283723 Buckles & Bows Pre-School Nursery Ongar Hill Addlestone Surrey KT15 1BP Tel: 01932 827556 E-mail: [email protected] </p><p>*I/We wish to go on the waiting list and understand that, if offered, I/we will have to pay £50 to confirm and guarantee the place. Please indicate if you’d be interested in joining the committee ……………………</p><p>From ………………………… (Date) (*Delete where applicable)</p><p>If we are offered a place which we no longer require, we will inform the pre-school as soon as possible. We understand that the £50 consists of a £25 non refundable Administration Fee, plus a £25 deposit which is held until the last invoice. Should we cancel the place prior to starting at Buckles and Bows we understand that we will forfeit the full £50 deposit. Once our child has started at Buckles and Bows if we fail to give 6 weeks written notice of withdrawing our child, we also understand that we forfeit this £25 refund.</p><p>Signature of parent …………………………………………………………………………….. Date………………………………………. Please make cheques payable to ‘Buckles & Bows Pre-School Nursery’ and return with form to: Lottie Saunders at the nursery tel: 07733 320950 ------ADMISSION TO BUCKLES & BOWS PRESCHOOL NURSERY ……………………………………………………………………………………………………………….. (Child’s name)</p><p>* A place will be available from ……………………………………………………… (Date)</p><p>* Your details are on the waiting list. We will notify you if a place becomes free.</p><p>Signed for the pre-school ……………………………… Name ………………………….. ………………… Date ……………………….</p><p>Buckles & Bows Pre-School Nursery Registered Charity No. 283723</p>