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Nursery Registration Form
Information on childcare choices www.childcarechoices.gov.uk
Financial Help/Information on tax-free childcare www.gov.uk/tax-free-childcare
1.
Nursery Place 2 Year Olds
Session Preference (please note this won't be guaranteed until the formal admission offer.
AM Session (8:45 am -11:45 am) 15 hours/week (government funded - working parents, code in place)
PM Session (12:45 pm-3:45 pm) 15 hours/week (government funded - working parents, code in place)
AM Session (8:45 am -11:45 am) 15 hours/week (benefit based Haringey Free for Two Offer in place)
PM Session (8:45 am -11:45 am) 15 hours/week (benefit based Haringey Free for Two Offer in place)
Full Time (9:00 am - 3:00 pm) from Sept.2025 (government funded - working parents, code in place)
2.
Nursery Place 3 Year Olds
Session Preference (please note this won't be guaranteed until the formal admission offer.
AM Session (8:45 am -11:45 am) 15 hours/week (government funded)
PM Session (12:45 pm-3:45 pm) 15 hours/week (government funded)
Full Time (9:00 am - 3:00 pm) 30 hours/week (government funded)
Paid Full Time (8:45 am - 3:45 pm) 15 hours/week (government funded) + 15 hours top-up £150.00 per week
3.
*Government Funded Places for 2 and 3 year olds - please provide the school with a valid code by the start of each term.
* Free for Two places - please provide the school with the Haringey Offer
Letter confirming your eligibility during the registration process.
* Please note for any funded places 6 week's termination/transfer written notice notice is required.
* For any additional top-up fees min. 1 week's written notice is required to cancel the payment arrangement.
Office email address: admin@lancs-pri.haringey.sch.uk
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*
4.
Legal Surname
(Required.)
*
5.
First Name
(Required.)
6.
Middle Name
7.
Known Name
*
8.
Gender
(Required.)
Female
Male
*
9.
Address - House Number & Steer Name.
(Required.)
*
10.
Address Postcode
(Required.)
*
11.
Date of Birth
(Required.)
12.
Home Telephone
*
13.
Mobile Number
(Required.)
*
14.
Nationality
(Required.)
*
15.
Country of Birth
(Required.)
*
16.
Do you identify with any of the following religions? (Please select all that apply.)
(Required.)
Protestantism
Catholicism
Christianity
Judaism
Islam
Buddhism
Hinduism
Native American
Inter/Non-denominational
No religion
Other (please specify)
*
17.
Ethnicity
(Required.)
White: British
White: Irish
White: Eastern European
White: Other
Mixed: White & Asian
Mixed: White & Black Caribbean
Mixed: White & Black African
Mixed: Other
Black or Black British: Caribbean
Black or Black British: African
Black or Black British: Other
Hispanic or Latino
Asian or Asian British: Indian
Asian or Asian British: Pakistani
Asian or Asian British: Bangladeshi
Asian or Asian British: Other
Chinese
Any other ethic group
Prefer not to say
*
18.
First Language
(Required.)
*
19.
Language Spoken at Home
(Required.)
20.
Does the child have a parent currently serving in the UK military?
Yes
No
*
21.
Is your child entitled to Free School Meals?
(Required.)
Yes
No
Not sure
*
22.
School Meal Required
(Required.)
Packed Lunch
Free School Dinner (if eligible)
Paid School Dinner (£2.50/day)
23.
What is your child's usual mode of travel to and from school?
24.
Parent/Carer 1 Salutation
Mr
Mrs
Miss
Ms
*
25.
Parent/Carer 1 Contact Details
(Required.)
Name
Surname
Address 1
Address 2
City
Postal Code
Email Address
Phone Number
*
26.
Parent/Carer 1 - Relationship to child (e.g. mother/father/aunt/uncle)
(Required.)
*
27.
Parent/Carer 1 - Parental Responsibility?
(Required.)
Yes
No
28.
Parent/Carer 2 Salutation
Mr
Mrs
Miss
Ms
29.
Parent/Carer 2 Contact Details
Name
Surname
Address 1
Address 2
City
Postal Code
Email Address
Phone Number
30.
Parent/Carer 2 - Relationship to child (e.g. mother/father/aunt/uncle)
31.
Parent/Carer 2 - Parental Responsibility?
Yes
No
32.
Emergency Contact 1 Salutation
Mr
Mrs
Miss
Ms
*
33.
Emergency Contact 1
(Required.)
Name
Surname
Address
Address 2
City
Postal Code
Phone Number
34.
Emergency Contact 2 Salutation
Mr
Mrs
Miss
Ms
*
35.
Emergency Contact 2
(Required.)
Name
Surname
Address 1
Address 2
City
Postal Code
Phone Number
36.
Please detail any court orders applying to the child (e.g Ward of Court, legal rights of access)
37.
If your child has any siblings who attend this school - please provide their name/s
*
38.
Medical Practise Details
(Required.)
GP Surgery Name
Family Doctor Name
Address 1
Address 2
City
Postal Code
Phone Number
*
39.
Do you give permission for the school to call the doctor in an emergency?
(Required.)
Yes
No
*
40.
Do you give permission for the school to administer first aid in an emergency?
(Required.)
Yes
No
41.
Please provide details of any medical conditions that the school should be aware of, and any emergency action that should be taken.
42.
Previous School Details
School Name
Company
Address 1
Address 2
City
Postal Code
Country
Email Address
Phone Number
43.
Please provide date of arrival to UK if no former school in UK
*
44.
Parental Permission- off-site trips/activities - participation
(Required.)
Yes
No
*
45.
Parental Permission- off-site trips/activities - receive first aid or urgent medical treatment
(Required.)
Yes
No
*
46.
Parental Permission- off-site trips/activities - visit places of worship
(Required.)
Yes
No
*
47.
Parental Permission - Child to walk home alone
(Required.)
Yes
No
48.
Consent form for use of digital images
In order to comply with the Data Protection Act 2018, we need your permission before we can photograph or make recordings of your child.
Examples of how digital photography and vide nay be used include:
-Your child being photographed (by the classroom teacher, teaching assistant or another child) as part of a learning activity; e.g. photographing children at work and then sharing the pictures in the classroom allowing the children to see their work and make improvements.
-Your child’s image for presentation purposes around the school; e.g. in school wall displays and presentations to capture images around the school or in the local area as part of a project or lesson.
-Your child’s image being used in a presentation about the school and its work in order to share its good practice and celebrate achievements, which is shown to other parents, schools or educators; e.g. in our school prospectus or on our school website, etc. In rare events, your child could appear in the media if a newspaper photographer or television film crew attend an event.
To safeguard your child we abide by the following rules for any external use of digital images:
-Only images of pupils in suitable dress are used.
-If the pupil is named, we avoid using their image. If their image is used, we avoid naming the pupil. Where showcasing examples of pupils work we only use their first names, rather than their full names. When showcasing digital video work to an external audience, we take care to ensure that pupils aren’t referred to by name on the video and that pupil’s full names aren’t given in credits at the end of the film.
-Staff are not allowed to take photographs or videos on their personal equipment.
Note: If we, or you, actually wanted your child’s image linked to their name we would contact you separately for permission, e.g. if your child won a national competition and wanted to be named in local or government literature.
Use of digital images – photography and video:
I have read and understood this agreement and agree to the school using photographs of my child or including them in video material, as described above. I understand that images will only be used to support learning activities or in publicity that reasonably promotes the work of the school, and for no other purpose.
Child's Name
Parent/Carer Name
Parent/Carer Surname
Date
*
49.
Parental Permission- Photographs/Videos for use within school premises
(Required.)
Yes
No
*
50.
Parental Permission- Photographs/Videos for use in school publications
(Required.)
Yes
No
51.
Parental Permission- Photographs/Videos for use on social media & the school website
Yes
No
*
52.
Remote Education - Do you have internet access at home?
(Required.)
Yes
No
*
53.
Remote Education - Is there at least one suitably sized device at home which can be used by your child for learning ( e.g. a tablet or computer, but not a phone)
(Required.)
Yes
No
*
54.
The device -if yes can your child use this device to input answers.
(Required.)
Yes
No
*
55.
Nursery Funding
Below information will be shared with the Local Authority to process the government funding. Without the National Insurance Number and DOB, we won't be able to offer the nursery places.
Free School Meal (FSM) Screen Check
The Free School Meal Checking Service is an online process where the school can check eligibility for free school meals. The School can conduct a simple online check to determine eligibility for free school meals which in turn may attract extra funding for each of their children’s schools.
(Required.)
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
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56.
Parent/Carer 1
Name
Surname
Maiden Name
Date of Birth
NI Number
57.
Parent/Carer 2
Name
Surname
Maiden Name
Date of Birth
NI Number
*
58.
Home & Partnership Agreement
At school we will try to:
-Provide a safe, secure and happy environment in which your child can flourish and achieve their best.
-Provide a broad and balanced curriculum and meet the individual needs of your child.
-Provide information about your child’s progress at Parent-Teacher consultations and in an annual report.
-Keep you informed about school activities and events through newsletters, letters or notices.
-Contact you if there are any problems with your child’s attendance, punctuality or equipment.
-Contact you and work with you, if there are any concerns about your child’s learning or behaviour.
-Encourage your child to grow into a responsible and valued member of the community.
Parent/Carer - At home, I/we will try to:
-Make sure that my child comes to school regularly, on time and properly Equipped.
-Make the school aware of any concerns or problems that might affect my child’s progress or behaviour
-Support the school’s policies and guidelines for behaviour
-Attend Parent-Teacher Consultations and other meetings about my child’s progress.
-Support and encourage my child’s learning to help them achieve their best.
Pupil - I will try to:
-Come to school regularly and on time.
-Bring all the equipment I need every day.
-Come to school appropriately and tidily dressed.
-Do all my work to the best of my ability.
-Respect others and be helpful and polite.
-Take good care of the equipment in school, the school building and its grounds.
-Follow the school Code of Behaviour
(Required.)
Agree
Disagree
*
59.
e-Safety Agreement
The School will:
-Monitor and review our e-safety policy on a regular basis.
-Support staff in the use of ICT as an essential tool for enhancing learning and in the embedding of e-safety across the whole school curriculum.
-Ensure that pupils are aware, through e-safety education, of the potential e-safety risks associated with the use of ICT and mobile technologies, that all e-safety concerns will be dealt with sensitively and effectively; that pupils feel able and safe to report incidents; and that pupils abide by the school's e-safety policy.
-Make information available to parents/carers to access e-safety information.
-Seek to learn from e-safety good practice and utilise the support of experts when appropriate.
Parent/Carer - I/We will:
-As the parent or career of the above pupil, I grant my permission for my child to have access to use of the Internet, school approved email account and other ICT facilities at school.
-Accept that ultimately the school cannot be held responsible for the nature and content of material accessed through the Internet and mobile technologies, but I understand that the school will take every reasonable precaution to keep pupils safe and to prevent pupils from accessing inappropriate materials. These steps include using an educationally filtered service, restricted access e-mail, employing appropriate teaching practice and teaching e-safety skills to pupils.
-Support the school by promoting safe use of the internet, school website and digital technology at home. I understand that overall it is my responsibility to monitor my child's use of the internet at home, know the content they are accessing and inform the school of any concerns.
Pupil - I will:
Never use mobile phones in school. If it is necessary to bring my mobile to school, I will make sure it is turned off and placed immediately in the secure box in the school office on arrival at school and I will collect it at home time. The school does not take responsibility for my mobile phone. My phone must have my name and class clearly labelled.
-Only delete my own files and not look at other people's files without their permission.
-Not bring files into school, or store personal files without permission.
-Ask permission from a member of staff before using the internet and will not visit internet sites I know to be banned by the school.
-Only email people my teacher has approved.
-Ensure that the messages I send, or information I upload, are always polite and friendly.
-Not open an attachment, or download a file, unless I have permission or I know and trust the person who has sent it.
-Not give our personal information or passwords.
-Tell the teacher immediately if I see anything I am unhappy with.
-Understand that if I break this agreement my right to use the school equipment may be withdrawn.
(Required.)
Agree
Disagree
*
60.
Lancasterian Primary School is committed to protecting the privacy and security of personal information. This privacy notice describes how we collect and use personal information about pupils, in accordance with the General Data Protection Regulation (GDPR), section 537A of the Education Act 1996 and section 83 of the Children Act 1989.
(Full GDPR available on http://www.lancasterianprimary.co.uk/GDPR)
(Required.)
Date
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Send me a copy of my responses via email