KiddiCove Day Nursery

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01928 733720

kerry@kiddicove.co.uk

KiddiCove Day Nursery & Pre School

April House, Tarvin Road, Frodsham, Cheshire, WA6 6XN

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KiddiCove Holiday Club - Registration Form

Please fill out all required fields marked*

Child's Details

First name*

Surname*

Birthday*

Day

Month

Year

Address*

Parent Name 1*

Parent Name 2

1. Relationship to child*

2. Relationship to child

1. Email*

2. Email

1. Phone*

2. Phone

Emergency contact details

I understand that if I am unable to collect my child, I will notify KiddiCove of the person authorised to collect them. I understand that if any person attempting to collect my child is not listed below KiddiCove cannot release my child without seeking my permission. (must be over 18 years of age)

Full Name

Phone Number

Relationship to child

Health and medical

Are your child’s immunisations up to date?*

Yes

Does your child have any food allergies, intolerances or special dietary needs?*

Yes

If yes, please specify

Does your child have any medical needs requiring ongoing medication?*

Yes

If yes, please specify

Does your child have any other Special Educational and or Disability Needs?*

Yes

If yes, please specify

Permissions

Please tick to consent *

In case of emergency Calpol can be administered

In case of emergency Piriton can be administered

Short trips and Outings

Sun Cream Factor 50+ children's sun cream will be applied if it has not been provided by parent/carer

Photography - I give permission for my Child’s Photograph to be taken and used for KiddiCove Facebook / Instagram / media and advertising purposes

I do not consent to any of the above

How did you hear about us?*

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

Full Name

Relationship to child

Signature*

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Date*

Day

Month

Year

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