Oakmere Primary School - Wraparound Care Registration Form

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Please complete this form to register your child to attend Breakfast and/or After School Club

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Child's forename *

Child's surname *

Child's date of birth *

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Class *

Nursery

Reception

Year 1

Year 2

Year 3

Year 4

Year 5

Year 6

Emergency Contact name & phone number (1) *

Emergency Contact name & phone number (2)

Name of adults (over 15 years of age) who are authorised to collect your child. *

Medical Information - please give details of any illnesses, allergies, medication etc. Please inform the school if any of these details change.

GP Surgery and telephone number *

Dietary Needs - please list allergies, and list any food your child is not allowed to eat due to food allergies or for religious reasons.

Agreement *

Agree

To the best of my knowledge, I have given all relevant information on my child's details.

Name of person completing this form and relationship to child. *

Date *

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Dieses Formular wurde bei Oakmere Primary School erstellt. Missbrauch melden

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