After School Care - Initial Registration Form
Name of Child *
Your answer
Form group *
Your answer
Name of Parent/Carer *
Your answer
Emergency Contact Number(s) *
Your answer
Is your child entitled to Pupil Premium? *
Nominated People
In order to ensure that your child is collected by the correct person, please provide the names of up to two nominated people who will collect your child from school. Include their relationship to the child and a password for additional security. Please notify the school if a person other than those nominated will be collecting your child on any given day.
Person 1 *
Your answer
Person 1 relationship (e.g. Uncle) *
Your answer
Person 1 phone number *
Your answer
Person 2
Your answer
Person 2 relationship
Your answer
Person 2 phone number
Your answer
Password (a code word that we can use to verify the person's identity) *
Your answer
Terms and Conditions
Full terms and conditions for this service are outlined on the school website. By submitting this form you confirm that you have read and agree with these. Printed copies are available on request
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