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Giggles After SchoolClub

REGISTRATION BOOKLET

CONFIDENTIAL

Childs Name ________________________

Main Contact ________________________Name

School ________________________

Class ________________________

Teacher ________________________

Please note that the information given in the booklet will be treated as confidential.

If there are any details that change after you have completed this booklet it is your responsibility to be sure such change is amended.

You must complete a separate booklet for each child that attends the club.

The information in this booklet is accurate at the time of printing; we reserve the right to change any policy/information and will notify you in writing of any changes.

We understand that this booklet asks a lot of information, but we ask you to understand that we need this information to offer you and your child the best childcare possible while they’re with us.

CHILDS DETAILS

Forename ____________________________________

Surname ____________________________________

Date of Birth ____________________________________

Age _______

Address ____________________________________

____________________________________

____________________________________

Number of Siblings__________ Place In Family __________

Sex of Child ____________________________________

Place of Birth ____________________________________

Childs Religion ____________________________________

Language ____________________________________Spoken At Home

ETHNIC ORIGIN

WHITE WHITE IRISH WHITE CARRIBEAN

BLACK AFRICAN BLACK CARRIBEAN BLACK BRITISH BLACK – OTHER

ASIAN INDIAN ASIAN BANGLADESHI ASIAN PAKISTANI ASIAN OTHER

CHINESE VIETNAMESE TURKISH CYPRIOT

MIXED – WHITE / CARRIBEAN MIXED – WHITE / AFRICAN MIXED – WHITE / ASIAN MIXED – OTHER

OTHER (PLEASE STATE)_______________________DO NOT WISH TO STATE

PRIMARY CONTACT INFORMATIONMOTHER /FATHER/ LEGAL GUARDIAN (Circle)

Forename: ______________________________

Surname: ______________________________

Email: ______________________________

Address: same as previous no need to repeat

________________________________________________

________________________________________________

________________________________________________

Contact No. 1 ______________________________ (home / main)

Contact No. 2 ______________________________ (mobile / 2nd)

Contact No. 3 ______________________________ (work / 3rd)

Mother / Legal Guardian Ethnic Origin







Secondary Contact Details Mother /Father / Legal Guardian/ __________ - other (circle)

Forename: ______________________________

Surname: ______________________________

Email: ______________________________

Address: same as previous no need to repeat

________________________________________________

________________________________________________

________________________________________________




FATHER / LEGAL GUARDIAN / 2nd CONTACT ETHNIC ORIGIN







Child’s Medical / Health Information

Does your child have any specific food allergies or any foods they are not allowed to eat? NO / YES

If yes list (nuts, etc)

__________________________________________

__________________________________________

__________________________________________space is provided at the end of this section if you need additional space

Does your child have any special needs? NO / YES

If yes explain

___________________________________________

___________________________________________

___________________________________________

Does your child have any visual problems? NO / YES

If yes explain

___________________________________________

___________________________________________

___________________________________________

Are Glasses Required YES / NO

Does your child suffer from any hearing problems? NO / YES (e.g. glue ear, partial / deafness)

If yes explain

___________________________________________

___________________________________________

___________________________________________

Child’s Medical / Health Information cont

Does your child suffer from any chronic or relapsing diseases or conditions, which for his/her safety staff should be aware of?(e.g. heart condition, epilepsy) NO / YES

If yes explain

____________________________________________

____________________________________________

____________________________________________

Does your child have any known sensitivity to drugs? NO / YES (e.g. aspirin, penicillin)

If yes explain

____________________________________________

____________________________________________

____________________________________________

Which of the following has your child been inoculated against?

Condition Aged 0 - 1 Years

Aged 1-4 Years

Aged5-8 Years

Aged9-11 Years

BCG and / or Hepatitis B for infants at riskDiphtheria, Tetanus and Pertusis (DTP)Hib (Haemophilus Influenzae b) for strain of meningitis.Meningococcal Type C

Polio

Measles, Mumps and Rubella or MMR

(tick appropriate box)


Has he/she had any of the following illnesses? (please tick)

Chicken Pox MeningitisConjunctivitis MumpsDiarrhoea and Vomiting RingwormDiphtheria Rubella (German Measles)Glandular Fever ScabiesHand Foot and Mouth Scarlet FeverHepatitis A ThreadwormsImpetigo TuberculosisMeasles Whooping Cough

Does your child have any history of allergic complaints? No / Yes (e.g. asthma, hay fever, eczema)

Allergy To What Medication Date of Last Occurrence, if regular (asthma) state as regular

Does your child have any other dietary requirements (not already stated) ? No / Yes

If yes explain

____________________________________________

____________________________________________

____________________________________________


Name of Doctor __________________________

Practice Name and Address __________________________

__________________________

__________________________

__________________________

Telephone Number _______________________________

Any Other Relevant Medical Information

Tea Time Questionnaire

In order for us to provide the best selection of food for the children we would like an indication of what your child likes or dislikes. We would prefer you completed this with your child for a true reflection of their taste preferences. LIKE DISLIKE

Cream Crackers

Croissants

Pancakes

Pita Bread

Pizza (cheese & tomato)

Crumpets

Chocolate Spread

Lemon Curd

Jam

Chicken Spread

Sandwich Spread

Cheese

Ham Slices (Turkey)

Ham Slices (Chicken)

Cream Cheese

Cereal

Collection Form

At Giggles we understand that on some occasions you may have to send another person to collect your child. To avoid unnecessary confusion please can you give a list of people that are allowed to collect your child. Please remember to inform us on days that you or the main person who usually collects your child will not be collecting them.

Name Of Person Relationship To Child Contact NumberMain Collector

2nd Person

3rd Person

4th Person

5th Person

Consent

Please read the following declarations and delete information where appropriate. Please sign and date at the end of declarations to confirm you have read and agreed to what you have left in each declaration.

Outings

I do / do not (please delete) give consent to my child/children going on outings with Giggles Childcare Services. This could be either by using private, public or council transport, walking or in Giggles Transit Van.

Photographs

I do / do not (please delete) give consent to my child/children being photographed at Giggles Childcare Services for the use of displays in the club, advertising (club literature and newsletters), training and education.

Student Training

I do / do not (please delete) give consent for students and trainees based at Giggles Childcare Services to include details of my child/children in reports and assignments relevant to their course of study. Your child’s name will not be used in these documents

Minibus Transport

I do / do not (please delete) give consent for my child to travel in the club mini bus. Please note Giggles Childcare Services mini bus is used for the majority of outings.

Emergency Transport

At times as a last resort we may choose to use one of the director’s cars to either collect / drop off or on an outing. The cars are insured for business use and all drivers have full UK driving licences.

I do / do not (please delete) give consent for my child to travel in a fully insured directors car.

Consent cont.Health / Medical

It could be possible that a child’s safety is put at risk if medication is not administered immediately by a member of staff e.g. epi-pen or asthma pump.

I do / do not (please delete) give consent for a senior member of staff to administer medication to my child in an emergency.

In an emergency situation it may be necessary to refer to or call upon emergency medical treatment e.g. an ambulance or hospital treatment.

I do / do not (please delete) give consent for Giggles Childcare Services staff to refer or call upon emergency treatment in an emergency

Giggles Mail

On occasions Giggles Childcare Services may hold special events such as trips and holiday schemes. If your child is not on the premises the day that material is released we may find it useful to post you a copy of the material.

I do / do not (please delete) give consent for Giggles Childcare Services to use my home address to send information that I may find interest in.

I have read and completed my response to all of the declarations above (outings, photographs, student training, minibus transport, emergency transport, health/medical and Giggles mail). I agree to inform Giggles Childcare Services if my decision changes regarding any of the consents I have given or not given,

Sign _______________________________________________

Date ____________ / _______________ / _________________

Manager Sign _______________________________________

Fees Applicable

One weeks fees are due in advance + £15 administration fee on registration*Parents are encouraged to pay fees directly into the Giggles Childcare Services bank account. There is a £ handling fee for each cash and cheque payment.

Fees** are due weekly and must be paid a week in advance. If a monthly payment system is agreed, fees owing cannot exceed 3 weeks. Any case where overdue payment is equal to or above 3 weeks could result in a child losing his/her place. All unsettled accounts will be referred to a debt collection agency which can seriously affect your credit rating

Child Collection Service

The Grove Centre & Elfrida Sites ; after school club runs from school collection until 6.00pm.

Athenley Site: after school club runs from school collection until 6:30pm.

We collect your child from school at home time***. At some sites we provide a walking bus for children from local schools. Unfortunately we cannot collect children if their school closes any earlier than its normal finishing time.

It is important that if you are collecting your child from the after school club you do so before 6.00pm. *6:30pm

**fees are correct at time of print*** usually 3:25pm or 2:30pm unfortunately we cannot collect children if their schools finish early

Parent / Guardian Agreement

It is important that both Parent and Carer are aware of the agreement that they are making in regards to the care of their children. Giggles Childcare Services will make every effort to ensure that your child is looked after safely. We will provide every child with the opportunity to feel safe, stimulated and confident. All children are different and it is vital in their development that this is taken into consideration. Giggles make sure that every individual child is given the opportunity to learn and play in a way that suits them.

Giggles Childcare Services

Fees

Please read and sign the following to show to us you are aware of your agreement with us. If you are not sure of your fees please complete in the presence of a member of staff

I __________________________________ (print name) am aware of and agree to the following;

I have/ am willing to pay a £15.00 administration fee.

Fees are due weekly and must be paid A WEEK IN ADVANCE. If a monthly payment system is agreed, fees owing cannot exceed 3 weeks. Any case where overdue payment is equal to or above 3 weeks could result in a child losing his/her place and may be referred to a debt collection agency for legal action.

I have paid £____________ as a deposit. It is equal to one week/month (delete) in advance.

My weekly / monthly fee is £_____________; and I agree to pay my fee on Friday(s) or ______________ either at the end of the week or month depending on payment schedule.

My child’s place is guaranteed only if I pay for it.My child must be collected from the hall no later than 6.00 p.m. (or 6:30pm at Athelney Primary School). Persistent lateness will result in additional charges being applicable on the day. Persistent lateness and no charges being paid will result in the loss of my child’s place.

Parent / Guardian Agreement cont

I must have no outstanding fees at the end/start of any term. All fees should have been paid by the last day of the closing term. Failure to clear accounts by the end of term can result in my child losing his/her place and/or legal action been taken against me.

Refunds will not be given if my child is unable to attend a day they are registered for**. However if childcare is unavailable due to staff shortage or any problem that is directly connected to Giggles Childcare Services, a refund will be given.

**NB Giggles Childcare Services is unfortunately unable to offer refunds/discounts on inset days. This is because inset days vary throughout the school term and the After School Service will still be available on these days. However if your child has an inset day on their first day back, this will not be included in their fees.

Two weeks notice is required in writing before withdrawing my child from the Club

Any outstanding fees must be settled before my child leaves

I am aware that a copy of the ‘Giggles Childcare Services Policies and Procedures’ is available to me on site for review at my request.

Giggles Childcare Services reserve absolute right to increase fees, amend and/or update its policies and procedures at anytime.

Parents Signature:_________________________________________

Date: _________________________________________

Manager Sign: _________________________________________

EMERGENCY CONTACT DETAILS

Please provide us with information of someone who we can attempt to contact if we are unable to reach either of the Parent(s)/Guardian(s) mentioned earlier.

Relationship ___________________________________To child

Forename: ______________________________

Surname: ______________________________

Address: ______________________________

________________________________________________

________________________________________________




EMERGENCY DROP OFF POINTPlease provide us with the address of someone who we could drop your child to if we cannot contact you or you are unavailable. This address should be close to your home.Only needed if child uses drop home service.

Relationship ______________________________To child

Forename: ______________________________

Surname: ______________________________

Address: ______________________________

________________________________________________

________________________________________________



Place offered:-

Start date offered:-

Comments:-

Please tick all the days you wish your child/children to attend. You must tick a min of 2 days.

(Please circle/delete) After School Club Full Time / Part time(Part time is 2-3 days)

Monday Tuesday Wednesday Thursday Friday

Home Drop Service Yes No (please circle)(Subject to status)

Preferred Start Date:-

Official use only:-

[End Of Booklet]

Fees Applicable2 days 3 days 4 days Full Time

Per Day £11 £10.50 £10.25 £10

The fee payment procedures still exist; Fees are due in advance Invoices will be sent out around the 18th of the month Siblings will still receive a 10% discount Non payment of fees will result in your child losing their place at

Giggles

The fee for our holiday scheme is £23 per day inclusive of our trip and fee(s) will be due a week in advance.

All payments must be made directly into our bank account – details of which are below. The reference for all payments should be your child’s first name and surname.

Please make all payments to:

Bank: NatwestAccount Name: Giggles Childcare ServicesSort Code: 60 24 77Account Number: 17711576

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