After School Club Enquiry Name Will be registered at The Lookout Day Nursery Date Of Birth 1st Parent/Carer Name 2nd Parent/Carer Name 1st Email Address 2nd Email Address Home Address What school does your child attend? Contact Telephone Numbers Carer 1 Carer 2 Additional Emergency Contact Are there any other professionals currently working with your child? (Speech and language, occupational therapist, social care etc) Please give details – Sessions Monday Tuesday Wednesday Thursday Friday PASSWORD FOR COLLECTION Fees Fees are payable monthly in advance on registered hours. Credit/rebates are not given for sessions missed by a child. All fees must be paid by the 15th day of the month, if not a 10% surcharge will be made. Health and Emergencies In case of emergency, all necessary steps will be taken to contact parent/guardian. In the event that this contact cannot be made, The Lookout Day Nursery reserves the right to seek medical attention. Doctors Name Telephone Doctors Address Medical Requirements Dietary Requirements Allergies Parental Consent Consent for off site Activities Yes No Consent to travel in Club Vehicles with suitable restraints Yes No Consent for non-prescribed drugs Calpol Yes No Nurofen Yes No Consent for applying sun cream Yes No Consent to use plasters on your child Yes No The Lookout Day Nursery GDPR & Photograph Consent Name of child Occasionally, we may take photographs of the children at nursery. We use these images as part of our displays and sometimes in other printed publications. We will also use them on our website and Facebook page. If we use photographs of individual children, we will not use the name of that child in the accompanying text or photo caption. If we name a child in the text, we will not use a photograph of that child to accompany the article. If a child has won an award and the parent would like the name of their child to accompany their picture we will obtain permission from the parent before using the image. Learning Journeys and Records of Achievement are used to celebrate your child’s progress throughout nursery. These are sent home at the end of the child nursery journey. Photographs of individuals or groups of children may appear in these records. From time to time, our nursery may be visited by the media who will take photographs or film footage of a high profile event. Children may appear in these images, which will sometimes be published in local or national newspapers, or on approved websites. To comply with the UK data protection legislation, we need your permission before we can photograph or make any recordings of your child. Please answer the questions below, then sign (or digitally sign) and date the form where shown and return or email the completed form to the nursery. I give permission for my child’s photograph to be used within nursery for display purposes Yes No I give my permission for my child’s image to be used in Learning Journeys/Records of Achievements belonging to other children Yes No I give permission for my child’s photograph to be used in other printed publications. Yes No I give permission for my child’s image to be used on our website. Yes No I give permission for my child’s image to be used on the nursery’s social media site (Facebook) Yes No I give permission for my child to appear in the media. Yes No I give permission for my child to have a nursery photograph taken by Lucy McGrath. I understand this printed/digital photograph can be purchased by parents. Yes No Conditions of use This form is valid indefinitely from the date you sign it. We will not re-use any photographs or recordings after your child leaves this nursery. Historic photographs will remain on our nursery website and the nursery’s social media feeds (Facebook). We will not use the personal details or full names (which means first name and surname) of any child or adult in a photographic image or video, on our website, on our social media platforms in our nursery prospectus or in any of our other printed publications. If we use photographs of individual child’s, we will not use the name of that child in the accompanying text or photo caption. If we name a child in the text, we will not use an individual photograph of that child to accompany the article. We will only use images of children who are suitably dressed, to reduce the risk of such images being used inappropriately. Websites can be viewed throughout the world and not just in the United Kingdom where UK law applies. I have read and understood the conditions of use on this form. Parent Acknowledgement of Email Sharing I (Parent), consent to sharing my email address with The Lookout Day Nursery. On leaving The Lookout Day Nursery my email address will be removed from all mailing lists. The Lookout Silwli Churchfields Village SchoolBA15 2QD Tel: 01225 858859 Hello@thelookoutdaynursery.co.uk 24, Park Rd, WhitchurchCardiff CF14 7BQ Tel: 02920 626720 Whitchurch@silwli.co.uk Learn more about Silwli » After School Club Enquiry At The Lookout we Nurture. Care. Inspire. Twitter Facebook Email Call: 01225 858859