COVID-19 Essential worker form
Please ensure that you are unable to remain in lockdown before completing this survey.
We can only care for children of essential workers *
Required
Parent first name *
Parent Surname *
Parent email address *
Parents workplace and role *
I have been required to work on the following days (only tick the days that you must work) *
Required
I need care for the following children. (Please give full name and class.) *
Please agree to these conditions of care: *
Required
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