Nursery Registration Form printable pdf download

Nursery Registration Form

Registration Form

117 Rosendale Road, West Dulwich, London SE21 8HE

020-8655-7000

Please complete this form in BLOCK CAPITALS LETTERS and return it to us with a non-refundable Registration Fee

of £15 made payable to Rainbow Smiles Ltd.

Child’s Details

Surname:_________________________________ First Name:_________________________________

Date of Birth:______________________________ Gender: Boy/ Girl

Address:_____________________________________________________________________________

____________________________________________________________________________

_____________________________________________________Post Code:_______________

Mother Details

Father’s Details

Name:____________________________________

Name:_____________________________________

Home Phone:______________________________

Home Phone:_______________________________

Work Phone: ______________________________

Work Phone: _______________________________

Mobile:___________________________________

Mobile:____________________________________

E-Mail:____________________________________

E-Mail:_____________________________________

Attendance Schedule:

Preferred Start Date:_________________________________________________ Full-time/ Part-Time:

Monday

Tuesday

Wednesday

Thursday

Friday

Morning

Afternoon

Full Day

NB: A minimum of 2 Full Days or 5 Morning or Afternoon Sessions are required to be taken up for Part-Time Attendance

Transport Survey

As part of Lambeth Council policy to promote more sustainable forms of Transport we are required to undertake a Survey. Lambeth

Council has recommended that anyone willing to use any sustainable form of transport be provided preference in our admissions

procedure: (Please Tick as appropriate)

Preferred Mode of Transport to Nursery: Walking ______ Bicycle: _____ Bus _____ Train ______ Car ______

Signature:_____________________________________ Date:________________________

Print Name:____________________________________ Relationship:__________________

Note: This Registration Form incorporates the terms & conditions overleaf. Upon signing this form the Parents are

deemed to have read, understood and agreed the same.

Nursery Registration Form