The Den Holiday Club at Ullesthorpe Pre-school Registration Form

The Den at Ullesthorpe Pre-school are pleased to offer a fun and engaging holiday club for children between the ages of 3-11 years of age. We strive to offer a welcoming environment that aims to promote independence and creativity throughout allowing the children to be apart of the planning of the sessions and tailoring them to meet individual needs and interests.  

We look forward to working in partnership with Parents/Carers to provide the best learning environment and opportunities for your child.

We require information

We need some information from you to ensure we can keep all children safe during their time at the holiday club, so could you please answer the questions within this form and return as soon as possible. This data is being collected for the purpose of essential information to comply with legal requirements and is in accordance with the General Data Protection Regulation 2018.  

Answering your questions

If you require any support in completing this form or have any questions then please contact the Pre-school on 01455 208375 or email ullesthorpepreschooloffice@gmail.com where a member of the team will be happy to help.
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Email *
Child's Legal Full name (inc Middle names) *
Child's preferred name
Child's Date of Birth *
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Address inc postcode *
Please list any medical conditions and medical allergies (e.g asthma/ allergy to penicillin)
Please list any dietary requirements and food allergies (e.g dairy, nuts etc)
Name of Doctors surgery and contact telephone number *
Special Education Needs & Disability
Please provide details of any special needs or medical care needs. We aim to be an inclusive setting and will endeavour to make reasonable adjustments to meet the needs of all children, however, if your child has any additional needs please contact us on ullesthorpepreschooloffice@gmail.com or contact Charlene on 01455 208375 so we can discuss how we can meet the needs of your child prior to the start of the club.
Please list Professionals involved with your child. Please include their name, agency and contact details
Is your child known to social care? *
If you have social care or other professionals involved with your child then please provide details and contacts.
Parent Responsibility Details
We are required to record the names and address of every person who has parental responsibility. Please provide the name, relationship, address, contact number and email for all persons with parental responsibility or the child.
*
Name of Parent/Carers with whom the child lives with if different from those with parental responsibility, to include name, relationship, contact telephone number.
Child's Ethnicity
Child's Spoken Language/s *
Religion
Please share with us any special celebrations/ events that your child celebrates or traditions that they take part in.
Additional comments that may support your child within the setting
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