Parent Declaration Form for the Early Education Free Entitlement

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Please complete this statutory form to enable us to confirm your entitlement to Free Early Education with Hull City Council.

This form is a legal requirement with the Government.
We may require a signed copy of this form at a later date.

Thank you

* Required question.

Email *

Your Child's Details

Child's Legal Surname *

Child's Legal Forename and Middle Names *

Name by which the child is known, if different from above.

Child's Date of Birth *

YYYY

Child's Gender *

Child's Nationality *

Child's Ethnicity *

Child's Religion (if any)

Child's First Language *

Child's Home Language *

Child's Address (including Post Code) *

I understand that I will need to provide my child's Birth Certificate/Passport as proof of my child's date of birth. Please bring this to the school office. *

Yes

Required

Disability Access Fund

If your child is 3 or 4, is receiving Disability Living Allowance and is receiving the free entitlement, he or she is eligible for Disability Access Fund (DAF). DAF is paid to your child's early years provider, the total is £850 per annum. The purpose of DAF is to support providers to make reasonable adjustments and build the capacity of their setting to support children with disabilities. The LA will need to see a copy of the award letter.

Is your child eligible for and in receipt of Disability Living Allowance (DLA)? *

Yes

Early Years Pupil Premium

Additional funding may be available through the Early Years Pupil Premium (EYPP), paid to early years providers for the provision of extra support for your child. EYPP is used to improve teaching and learning facilities and resources so as to impact positively on your child's progress and development. The payment equates to £114 per term.

We will check eligibility of your child unless you let us know otherwise.

Setting and Attendance Details (If your child will be attending two settings e.g. another nursery or childminder)

You need to agree and complete this Declaration Form with each setting your child attends for their early education entitlement of 15 or 30 hours per week in order to ensure that funding is paid fairly between them. Your child can attend a maximum of two sites in a single day and if your child attends more than 1 setting, Hull City Council will distribute the funding fairly between the settings.

Please let us know below if your child will also be attending another setting. (Please include days and times that your child is attending. This includes other nurseries/childminders etc.) *

I confirm that the information I have provided above is accurate and true. I understand and agree to the conditions set out in this document and I authorise Ings Primary School to claim free entitlement funding as agreed above on behalf of my child.

I confirm and agree to the above statement

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Parents Notes

Eligibility Criteria for the Free Entitlements

Note 1: eligibility criteria for the free entitlements for 2, 3 and 4 year old children can be found on line:

Help with Childcare Costs – for 2-year-olds
Help with Childcare Costs – for 3-and 4-year-olds

Note 2: Early Years Pupil Premium (EYPP) is an additional sum of money paid to childcare providers for 3 & 4 year olds of families in receipt of certain benefits. Based on their universal access hours only.

Further information about EYPP and DAF is included in the Operational Guide for Local Authorities 2018-2019, which can be found on gov.uk. Alternatively, for more information please speak to your childcare provider or Hull City Council.

Data Privacy

The Data Protection Act 2018 (the Act) puts in place certain safeguards regarding the use of personal data by organisations, including the Department for Education (DfE), local authorities, schools and other education providers. The Act gives rights to those about whom data is held (known as data subjects), such as pupils, their parents and teachers. This includes:
 the right to know the types of data being held
 why it is being held, and
 to whom it may be disclosed

Should you have any concerns relating to how your information or the information relating to your child/ren is being or will be used, please contact your Provider or Hull City Council. Please note that the information about whether a child is in receipt of Disability Living Allowance is, under the Act, Special Category Data which should be handled appropriately. Providers are asked to pay particular note to advice from the Information Commissioners Office on holding personal data including sensitive personal data available at: https://ico.org.uk/for-organisations/guide-to-data-protection/principle-3-adequacy/

A ‘privacy notice’ is a good way to be able to meet data subject’s rights and therefore DfE recommend they are used to explain to parents, pupils and staff how their data is being used. They should be reviewed, amending as necessary to reflect business need and ideally include the link to the gov.uk webpage on how the department collects and shares data. It is recommended that the privacy notice be included as part of an induction pack for staff and be put on the school website for parents, as well as potentially featured on the staff notice board/intranet. They do not need to be issued on an annual basis as long as new pupils and staff are made aware of the notices and they are readily available electronically or in paper format.

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