Child Registration Form Nursery
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First Name of Child (if unknow please answer Baby) *
Middle Name of Child
Surname of Child
Preferred Name of Child
Address of Child
Child's Date of Birth (or due date if applicable) *
MM
/
DD
/
YYYY
Parent/Carer Information
Title and Name of Parent/Carer 1
Address Of Parent/Carer (if different from child)
Mobile Phone Number *
Other Contact Number
Email address *
Title and Name of Parent/Carer 2
Address of Parent/Carer 2 (if different from Child)
Mobile Phone Number  *
Other Contact Number
Email Address
Emergency Contact 
Relationship to Child
Emergency Contact Phone Number
What are your preferred days at nursery
Please use this box to inform us about any additional needs, allergies or intolerances.  
Please add your preferred start date *
MM
/
DD
/
YYYY
Thank you for completing the registration form, a member of our management team will be in touch as soon as possible
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