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Registration Form

 
Gender
Boy
Girl
Prefer not to say
Other
Date of birth
Day
Month
Year

Please enter a valid phone number.

Designated persons authorised to collect your child (on receipt of specific instructions only)

Health & Medical

Name & Address of Family Doctor

Attendance

Preferred start date (by term)

Preferred times of attendance:

Morning
Afternoon
Has/does your child attended any other nurseries?
Yes
No
Will your child be attending any other nurseries?
Yes
No

I/we confirm that I/we have read, understood and retained the information attached to this form and that our signature(s) below is our acceptance of these terms and conditions.

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Date
Day
Month
Year

Add your text

Please enclose or transfer the registration fee of £75.00 which must be paid before your child can be put on the list and it is.


Please remit to: Nat West, Beckett House Limited.


Sort Code: 60-18-20

Acc. No: 96849401


Please note:

Acceptance onto the waiting list does not guarantee a place.

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