Parent Contact Details

Name of child*

First Last

Child's date of birth*

Name of Parent*

First Last

Home Address*

Street Address Address Line 2 Town County Postcode Country

Phone*

Email*

Enter Email Confirm Email

Date of Application

Preferred Sessions

For Babies the minimum attendance is 1 Full day and 1 Half day. For children 2, 3 and 4 year old's the minimum attendance is 2 Full days.

Monday

Tuesday

Wednesday

Thursday

Friday

Date childcare is required

Previous Childcare

How did you hear about us?

On receipt of your information we will contact you to acknowledge receipt. Our busiest age groups are babies and the pre-school and there can sometimes be a waiting list. However we will be in touch to let you know how soon we are able to accommodate you. Once a place has been offered, a deposit is required within 7 working days to secure those sessions. The deposit is £100 which is deducted from your first invoice. Should your child subsequently not take up the place this deposit is non-refundable.

If you find that you no longer need the place, please inform us as soon as possible and we will not retain the details on this application form.

I agreed the above statment*

Yes

Preferred Sessions

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