Welcome to Ladels Day Nursery!

We are delighted that you are considering Ladels Day Nursery for your child’s early years education. Please complete this form accurately and in full to ensure we can provide the best possible care and support for your child.

If you have any questions while filling out this form, feel free to contact us at:

📧 Email: info@ladelsdaynursery.co.uk

📞 Phone: 020 8764 4343

Child’s Details

Child's Full Name

Child’s Full Address

Date of Birth

Gender
MaleFemale

Ethnic Origin
IndianPakistaniBangladeshiChineseAny other Asian backgroundCaribbeanAfricanAny other Black, Black British, or Caribbean backgroundWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed or multiple ethnic backgroundEnglish, Welsh, Scottish, Northern Irish or BritishIrishGypsy or Irish TravellerRomaAny other White backgroundArabAny other ethnic group

Religion

What Language Does Your Child Speak?

Will your child be attending the nursery on a full-time or part-time basis?
Full-time (5 days per week)Part-time

If part-time, please select the days your child will attend:
MondayTuesdayWednesdayThursdayFriday

Does your child have any special requirements that would help them settle into the nursery?

30hrs eligibility funding code

2-year-old eligibility funding code

Main Carer Details

Parent/Carer Full Name

Relation to Child

Parent/Carer’s Full Address

Contact Number

Email Address

Occupation

Secondary Carer Details

Parent/Carer Full Name

Relation to Child

Parent/Carer’s Full Address

Contact Number

Email Address

Occupation

Emergency Contact

1st Emergency Contact Name

Relation to Child

Contact Number

2nd Emergency Contact Name

Relation to Child

Contact Number

Medical History

Name of Your Child’s Medical Practice

Full Address

Your Child Doctor’s Name

Child’s Health Visitor’s Name

Contact Number

Does your child have any medical conditions we should be aware of?

Does your child receive any of the following support services? Please select all that apply.
Speech TherapyRespite CarePortagePhysiotherapyNoneOther

About Your Child

Does your child have dietary restrictions and/or Food Preference?

Does your child have favourite toys and activities at the present time?
YesNo

If yes, please list below:

Does your child have any favorite toys or activities at the moment?
YesNo

If yes, please list below:

Has your child attended any other playgroup or childcare setting? If so, how did they respond to the separation process?

Is there anything your child is afraid of or dislikes doing?

Is your child accustomed to playing with other children? Do they enjoy social play?

What do you think your child will enjoy most about coming to nursery?

Do you feel your child’s development is in line with what you expect for their age?

Do you have any concerns about your child’s development?

How independent is your child in the following areas?
Dressing themselvesUsing the toilet independentlyChoosing activitiesExpressing their feelingsOther (please specify):

Are there any physical or personal care routines you follow at home that you would like us to continue at the nursery?

Babies Section

Is Your Child under 1 Year Old?
YesNo

How does your child prefer to sleep?

How does your baby like to be comforted when they are upset?

What is your baby's feeding routine?

Consent

At Ladels Day Nursery, we require parental consent for certain activities and procedures to ensure your child’s well-being, care, and development. Please review the following and tick the appropriate boxes to indicate your consent.

Seeking medical emergency treatment and advice
YesNo

Administering prescribed medication (as per nursery policy)
YesNo

Providing general care treatment (e.g., applying sun cream/block provided by parent)
YesNo

Conducting head lice and nits inspections
YesNo

Taking photos for nursery use(newsletters, nursery website, displays)
YesNo

Washing and changing my child if necessary
YesNo

Observing and documenting developmental progress
YesNo

Taking my child on local outings (e.g., parks, shops, library)
YesNo

Displaying my child’s photo and information on the Blossom Educational App
YesNo

I confirm that I have read and understood the above permissions. I consent to the selected activities for my child while attending Ladels Day Nursery.

General Data Protection Regulation (GDPR) Policy

[Detailed GDPR policy as provided, including commitments, principles, data collection, processing, protection measures, rights, and contact details.]

Partnership Agreement

We will work in partnership to provide the best care and learning for your child. Please confirm that you agree with the following:

I agree to abide by and adhere to the policies of Ladels Day Nursery
I agree to pay on time and/or provide all details for acquiring nursery fees

Feedback

Where did you hear about us?
Word of MouthSocial MediaGoogle SearchNursery WebsiteLocal AdvertisementOther

What made you choose Ladels Day Nursery?

Any suggestions for improvement?

Declaration

I hereby confirm that the information provided in this application is accurate, complete, and correct. I also certify that any documents submitted alongside this application are genuine. I understand that it is my responsibility to promptly notify Ladels Day Nursery in writing of any changes to the information provided. Additionally, I agree to update this form whenever requested to ensure all records remain accurate and up to date.

Write your name in full and Submit the form to confirm

Δ