Hylton Red House Nursery School

Registration Form

Secure Registration Form

Thank you for enquiring about a place for your child in our nursery. Please complete the information below in order to secure a place on our waiting list. Someone will contact you nearer the time to make arrangements for your child's start date.

Child's Legal Forename:

Child's Legal Surname:

Child's Date of Birth:

Sex

Language(s) spoken:

Child's Address:

Postcode:

I am applying for the following (please tick all that apply):

I have a 30 hours code (please write the 11 digit code):

I have a funded two year old eligibility code / reference number:

Does your child fit into any of the following categories:

Does your child have any special educational or medical needs?

Primary Parent/Carer title:

Primary Parent / Carer Name:

Primary Parent/Carer Date of Birth

Primary Parent/Carer Telephone:

Primary Parent / Carer National Insurance Number:

Primary Parent/Carer email address:

Who has Parental Responsibility (which names are on the Birth Certificate?):

Preferred session:

I agree that the school can contact an outside agency ie Health Visitor, Speech Therapist etc. so they can provide information about my child to support their learning in school:

Name of Child's Doctor:

Name of Child's Health Visitor:

I give permission for the nursery to check my eligibility status with the relevant benefit providers. I agree to inform you immediately if my benefit stops or changes.

Which of our nurseries are you applying for?