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Dolphins Childcare
North Petherton
dolphinscc@btconnect.com
01278-661333
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Nursery
Toddlers
Pre-School
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What’s On?
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Home
About
Welcome
Values
Curriculum
Staff
Terms & Conditions
Children
Nursery
Toddlers
Pre-School
SEND
Parents
Information
Stay and Play
Tapestry Journal
Ofsted Report
Registration
What’s On?
Gallery
contact
Childcare Registration
Child Details
First Name
Middle Name
Last Name
Gender
Male
Female
Gender Neutral
Transgender
Date Of Birth
Age
Street Address
Town/City
County
Postal Code
Home Phone
Parent/Carer Details
Parent/Carer 1
Parent/Carer 2
Name
Name
Street Address
Town/City
County
Postal Code
Street Address
Town/City
County
Postal Code
Phone
Phone
Email Address
Email Address
Does This Person Have Legal Parental Responsibility?
Yes
No
Does This Person Have Legal Parental Responsibility?
Yes
No
Childcare Required
Care Required
Nursery
Toddlers
Pre-School
Breakfast
After School
When would you like your child to start?
Monday
Tuesday
Wednesday
Thursday
Friday
Child's Food Requirements
Hot Meal Lunch
Afternoon Tea
Dietary Requirements
Does Your Child Attend Any Other Setting?
Yes
No
Are We Allows to Share Information Regarding Development & Care with them?
Yes
No
Are Any Other Agencies Involved?
Yes
No
Who Will Be Bringing & Collecting Your Child?
Emergency Contacts
Name
Phone
Name
Phone
Name
Phone
Name
Phone
Additional Details
First Language
Spoken At Home
Religion
Nationality
Are There Any Celebrations/Festivals That You Wold Like Us To Celebrate As Part Of Your Culture?
Medical
Name Of Doctor
Surgery Phone
Street Address
Town/City
County
Postal Code
Name of Health Visitor
Does Your Child Have Any? Allergies / Illness / Medication / Special Needs
Immunisations: Are The Child's Immunisations Up To Date?
Yes
No
Has Your Child Had Any Of The Following Illnesses?
Chicken Pox
Diarrhoea & Vomiting
Conjunctivitis
Impetigo
Slapped Cheek
Scarlet Fever
Hand, Foot & Mouth
Confirmation
Name Of Person Completing This Form
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