Registration Form | Cippenham Nursery School

Short Consent Form (Appendix H) & Nursery Registration Form

Under the Data Protection Act 2018, we are required to gain your permission to keep personal details for you and your children on our database. Slough Borough Council and its agents may share this information with government and local authority departments and other authorised organisations for administrative, statistical and research purposes. For further information please visit: Slough Data Protection

Completing the forms below and submitting them gives us your informed consent. If you are unable to access the provided link or wish to submit a query in relation to fair processing, please contact the data protection officer to: DataProtectionOffice@slough.gov.uk

I have read and understood the statements above and would like to apply for a free early education place for my child by submitting the forms below.

Registration Form

Child's First Name:

Max length 120 characters

Child's Last Name:

Max length 120 characters

Child's Gender: *

Select

Child's DOB:

Max length 120 characters

Are you seeking asylum? *

Select

If seeking asylum, please tell us when your child arrived in this country:

Max length 120 characters

Which funding are you looking for? *

Select

Which session you would prefer at Cippenham Nursery? *

Select

Full Address INCLUDING Post Code:

Max length 120 characters

Primary Parent / Carer Full Name:

Max length 120 characters

Relationship to Child: *

Select

If other, please specify relationship to child:

Max length 120 characters

Primary Parent / Carer Contact Number:

Max length 120 characters

Primary Parent / Carer Email:

Max length 120 characters

Parent / Carer Full Name

Max length 120 characters

Relationship to Child:

Select

If other, please specify relationship to child:

Max length 120 characters

Parent / Carer Contact Number:

Max length 120 characters

Parent / Carer Email:

Max length 120 characters

Does the child have any siblings? *

Select

Have any siblings attended Cippenham Nursery School? *

Select

Siblings DOB & Current School Attending

Max length 500 characters

Does your child have a Child Protection Plan? *

Select

Is English your spoken home language? *

Select

Home Language if not English:

Max length 120 characters

Support Required with English?

Yes - For Parent(s) / Carer(s)

Yes - For Child

Does your child attend any other childcare provision? Please name (example: Childminder, Another Nursery)

Max length 120 characters

Does your child have any of the following?

Allergies

Hearing Difficulty

Sight Problems

Speech and Language

None

Is there anything you think we need to know about your child or family (e.g. family setup, additional support)

Max length 120 characters

I understand that I must also submit the Short Consent Form (Appendix H) for my application form to be accepted. *

Select

Short Consent Form (Appendix H)

I confirm that I am the legal parent / carer for the child named below and that the information on this form is correct. I agree that you may use the information I have provided to process my claim for a free early education place and to contact other sources, as allowed by law, to verify my initial and ongoing entitlement. I agree that the information may be used to assess further benefits for my child and my child's school (or other setting), to ensure accuracy of records across the local authority and th check against fraud. I agree that my chosen early years provider may share information about my child's progress as part of ongoing research to support the development of services for young children in Slough.