General Information

Step 1/10
Child's Full Name
Preferred Start date
Preferred Name
Ethnicity or cultural background
Date of birth

Family Information

Step 2/10
Position in family
Parents marital status
Language spoken at home

Medical & Dietary information

Step 3/10
Has permission to have medicine administered (eg. Calpol)
Medical Information
Has permission to have adhesive dressing applied
Has permission to have suncream applied
Has permission to have nappy cream applied
Has permission to have face painted
Allergies Details
Has permission to consume nut traces
Dietary Preference
Additional Notes

Nursery Information

Step 4/10
What do they drink from?
Does the child sleep during the day?
Do they have any special need (SEND)?
Do they have English as an additional language (EAL)?
Is the child serving armed forces personnel?
Child receives two year funding?
Child receives EYPP funding?
Has permission to be in media?
Has permission to be in group media?
Has permission to be shared on social media?
Has permission for media to be shared on other marketing material?

Likes and dislikes

Step 5/10
Other Interests
Fussy eater
How are they with other children and/or family members?
Do they have a lot of language?
What are their physical skills?


Step 6/10
Does your child attend another setting?
What is your child's normal routine?

Contact Information | 1st Contact

Step 7/10
First Name
Mobile Number
Work Number
Access to parent app
Receive news posts via email
Receive diary via email

Contact Information | 2nd Contact

Step 8/10
First Name
Mobile Number
Work Number
Parental responsibility
Access to parent app
Receive news posts via email
Receive diary via email

Booking Pattern

Step 9/10
Session Hours

Permissions & Declaration

Step 10/10

I give permission for the SENCo to contact other professionals involved with my child. (e.g. Health visitor)


We take a lot of photos of the children to record their achievements and making class books. These are only used within the setting - we do not use photo for publicity without specific permission.

Displayed Details

If applicable a photo, name and brief description of dietary allergies/requirements are displayed by the kitchen snack bar and first aid box in the kitchen.

Emergency treatment declaration

In the event of an accident or emergency involving my child I understand that every effort will be made to contact me immediately. Emergency services will be called as necessary and I understand my child may be taken to hospital accompanied by the setting manager (or authorised deputy) for emergency treatment and that health professionals are responsible for any decisions on medical treatment in my absence.

For inhalers/Auto injectors (e.g epipens) only

I give permission for a member of staff who has been appropriately trained to administer the inhaler/epipen or apapen (supplied by me) to my child

Named staff are

We would like to send you information about Towntree Such as newsletters or invitations to events. Please tick the relevant boxes to indicate if and how you are happy for us to contact you


I confirm all details provided are correct

Thank you for filling out this form!

We will be in touch if there is anything to discuss.
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