Nursery New Starter Forms

Child's surname* Child's first name* Other names Name by which child is known

Gender*MaleFemale

Date of Birth (please use drop down box)* Address* Post Code* Child' National Health Number*

Name(s) of sibling(s) who currently attend Bonneygrove School
	Name	Class
Child 1
Child 2
Child 3
Child 4

Previous playgroup/nursery schools attended
	Name/address	Dates attended from / to
1
2
3

FAMILY AND EMERGENCY CONTACT DETAILS

We MUST have at least two contacts in case of an emergency.

Please let us know of any changes in contact details as soon as possible. It is essential that the school can make contact with you quickly, if needed.

Please note in the case of parent separation, unless there is a Court Order, both parents should be detailed in order of priority.

Parent/Carer 1

First name* Surname* Address* Relationship to child* Home telephone number Mobile number* Work number and extension (if applicable) Email address*

Are you a member of the Armed Forces*YesNo

Parent/Carer 2

First name* Surname* Address Relationship to child* Home telephone number Mobile telephone number* Work number and extension (If applicable) Email address

Are you a member of the Armed Forces*YesNo

Parent/Carer 3

First name Surname Relationship to child Mobile telephone number

Parent/Carer 4

First name Surname Relationship to child Mobile number

NAMES OF ADULTS WHO ARE PERMITTED TO COLLECT YOUR CHILD

In order to minimise security risks at the end of the school day, it is essential that the school know who is authorised to collect your child from school. It is expected that all children in KS1 or younger will be collected from the classroom and not from the gate.

It is strongly recommended, in most circumstances, that older brothers and sisters in the school do not collect younger siblings.

Please rank the following*
	Name of Adult	Relationship to child

Please tick*I understand that the school has a legal duty to report any safeguarding concerns to the relevant authorities without parental consent where there is a risk of harm.I further understand that, if my child is late being collected from school, then the school has a duty to inform the relevant authority, when this becomes persistent.

MODE OF TRANSPORT

OUTSIDE AGENCIES

Does your child have a Statement of Special Education Needs*YesNo

Has your family or child had contact with any of the following:-

Child Family Guidance Education Psychologist*YesNo

Educational Welfare Officer*YesNo

Speech Therapist*YesNo

Child Development Centre*YesNo

Social Worker*YesNo

Other agencies/information the school needs to be aware of (please specify)

MEDICAL INFORMATION

Are your child’s immunisations all up to date?

MMR*YesNo

Pre School Booster*YesNo

Does your child suffer from any of the following conditions? (please tick all those relevant)

Has your child had any serious illnesses/accidents that required hospitalisation : Other illnesses the school should be aware of (please specify)

Is your child taking regular prescribed medication at home (outside school hours)?

Select one of the following*YesNo

If so, please provide further Information Please provide any further concerns you would like to mention / on-going investigation for a medical condition :

Does your child have a special medical dietary requirement (as confirmed by a GP) :*YesNo

Please provide additional information regarding your child's special medical dietary requirements as confirmed by a GP.

Does your child require a special menu for cultural or religious reasons :*YesNo

If applicable, please tick which applies :My child does not eat porkMy child does not eat beefMy child only eats Halal foodsMy child only eats Kosher foods

ALLERGIES

What is your child allergic to:


What are the symptoms:


If treatment is need please provide further information

ASTHMA QUESTIONNAIRE

Family Doctor Details*

Name of Practice / Surgery
Address
Telephone Numbers

Can the GP be contacted for information when/if required?*YesNo

We comply with the requirements of the Hertfordshire Schools Asthma Policy and request that you complete an Asthma Maintenance Plan when your child joins the school, which will be updated each academic year.

The information will be used by staff in school to provide appropriate care and support during school hours.

Inhalers must be clearly labelled with your child’ name and date of birth, and remind you that it is the parents/carers responsibility to ensure that inhalers are in date and replaced as needed. If your child has an inhaler in school we MUST also have a spacer for this in school.

Children are not permitted to have/carry any medication in their bag during the school day.


When was your child diagnosed with Asthma?


What triggers your child's Asthma (if known )

Is your child’s asthma (please tick as appropriate)Mild – uses reliever blue inhaler occasionallyModerate – uses preventer and occasionally blue inhalerSevere – uses preventer, regular reliever and other medication

Does your child have disrupted sleep due to his/her asthma (please tick as appropriate)RarelyOccasionallyFrequently

How many times (if any) has your child attended Accident & Emergency with an acute asthma attack in the past year?Not attendedOnce or moreState how many times below

How often is your child seen by the hospital / GP/ Practice Nurse (please tick as appropriate)Only when he/she has an asthma attackOn a 3-6 monthly (or more frequent basis)Annual check by GP

What inhalers / medication has your child been prescribed?

Reliever (Name)
Preventer (Name)
Other (Name)

LANGUAGE DATA

A first language other than English should be recorded where a child was exposed to the language during early development and continues to be exposed to this language in the home or in the community.

If a child was exposed to more than one language (which may include English) during early development the language other than English should be recorded, irrespective of the child’s proficiency in English.

In the case of an older pupil who is no longer exposed to the first language in the home, and who now uses only another language, the pupil or parent can determine which language should be recorded.

Other Language .....(only use if your language is not listed above)

ETHNIC BACKGROUND

Our ethnic background describes how we think of ourselves. This may be based on many things including, for example, our skin colour, language, culture, ancestry or family history. Ethnic background is not the same as nationality or country of birth.

The DfE recommends that those with parental responsibility decide the ethnic background for primary pupils. The Information Commissioner (formerly the Data Protection Register) recommends that young people aged over 11 years old have the opportunity to decide their own ethnic identity. Parents, or those with parental responsibility, are asked to support or advise those children aged over 11 in making this decision, wherever necessary.

Please study the list below and tick ONE box only to indicate the ethnic background of your child.

Section B-MixedWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed background

Section C — Asian or Asian BritishIndianPakistaniBangladeshiAny Other Asian Background

Section D- Black or Black BritishCaribbeanAfricanAny Other Black Background

Section E-Chinese

Section F-Any Other Ethnic Group

I do not wish an Ethnic background to be recorded

RELIGIOUS BACKGROUND

Any information you provide will be used solely to compile statistics on the school careers and experiences of pupils from different ethnic backgrounds, to help ensure that all pupils have the opportunity to fulfil their potential. These statistics will not allow individual pupils to be identified. From time to time the information will be passed on to the Local Authority and the Department for Education and Skills (DfES) to contribute to local and national statistics. The information will also be passed on to future schools.

WISEPAY

The School currently uses an outside provider to send emails/texts to families. In order to use WisePay® we need to collect parent/carer email addresses and mobile telephone numbers. Please be assured the Wisepay service is registered with the Data Protection Register and guarantees that all information supplied will be kept completely private. There is also NO advertising associated with the scheme.

This system is used by over 2,500 school across the UK to communicate with parents via email and text message. Benefits of using an electronic communication system are:
• Messages will get to you reliably.
• We can send messages directly to both parents/carers at the same time.
• Parents/carers will quickly know about important or urgent messages.
• We can tell you more about what’s going on at the school.
• Make payments for trips, dinner money, clubs, Kool Kids, swimming etc.

WisePay is also a secure, fast and easy online payment system for parents/carers to make payment using their debit or credit card. Cash/cheques are not accepted as a payment method.

Access to Wisepay is through the School website.

Please be assured that WisePay is registered with the Data Protection Register and guarantees that all information you provide will be kept private and will not be passed on to any other organisation. Please refer to the Wisepay Privacy Policy.

Important – When we start using WisePay, email messages will be sent from noreply@wisepay.co.uk. Please add this address to your email address books (or approved sender list) to prevent messages from being blocked by your SPAM/JUNK filters.

If for any reason, you would prefer paper copies of communications e.g. newsletters, letters etc. then please contact the school office.

Parent/Carer Details
	Parent/Carer 1 details	Parent/Carer 2 details
Title
First name
Surname
Email address
Mobile number
Relationship to child

I give my permission for my email address and mobile number to be registered with WisePay®.* Name of parent/carer giving consent* Date*

EARLY YEARS PUPIL PREMIUM APPLICATION - NURSERY

Completion of this section will help us to provide the best education and support for your child by making sure that if your child is eligible for the Early Years Pupil Premium (EYPP) that we receive this funding. Please note that completion of this section is voluntary. However, if you do not complete this form we will not be able to identify whether your child is eligible for the EYPP and we may not receive additional funding to support your child.

Parent/Carer Details
	Parent/Carer 1	Parent/Carer 2
Full Name
Date of Birth
National Insurance No.
or National Asylum Support Service (NASS) No.
Address

I am (or my partner) is in receipt of the following benefits:*Income SupportIncome Based Jobseekers AllowanceIncome related Employment and Support AllowanceUniversal CreditSupport from NASS (National Asylum Support Service) under part 6 of the Immigration and Asylum Act 1999the guarantee element of State Pension CreditChild Tax Credit (with no working Tax Credit)with an annual income of no more that £16,190Working Tax Credit run-onI (or my partner) do not receive any of the above benefits

Any personal data collected will be treated as confidential under the principles of The General Data Protection Regulations.

Hertfordshire County Council will use the information submitted to assess your eligibility for education benefits. They will not use the data for any other purpose, nor will they share your data with any third parties other than the Department for Education if you are applying for Free School Meals.

DECLARATION
The information I have given on this form is complete and accurate. I understand that my personal information is held securely and will be used only for local authority purposes.
I agree to the local authority using this information to enable my child’s school to claim the Pupil Premium for my child.

I give permission for Bonneygrove Primary School to check my eligibility* Name of parent/carer giving consent* Date*

SAFE USE OF IMAGES

Increasingly, schools are using photographic and video images of children to enhance learning and life within the school. This is important in taking a creative approach to teaching and learning and in making lessons and activities as enjoyable as possible for children.

Members of staff may use photographs/videos in presentations, in subsequent lessons or to celebrate successes through their publication in Newsletters, school events, curriculum work, display purposes, productions, trips, local newspapers and sporting events. Photographs/ videos may also be used on the School Website and School Prospectus.

The Bonneygrove E-Safety Policy is available to view on the school website.

We would like to request blanket consent for the use of your child’s image. This form is valid for the period of time that your child attends Bonneygrove.

I give consent for my child's image to be published as detailed above* Please provide specific information regarding particular areas that you DO NOT wish your child's images to be use in. Name of parent/carer giving consent* Date*

PUPIL ACCEPTABLE USE AGREEMENT / ESAFETY RULES

ICT including the internet, email, laptops, digital cameras etc. has become an important part of learning in our school. We expect all children to be safe and responsible when using any ICT.

Please discuss these Esafety rules with your child. If you have any concerns or would like some explanation please contact the ICT Subject Leader or the Headteacher.

I will only use ICT in school for school purposes.

I will not deliberately look for, save or send anything that could be unpleasant or nasty. If I accidentally find anything like this I will turn off my monitor and tell my teacher immediately.

I will not send to children or adults anything that could be considered unpleasant or nasty.

I will be responsible for my behaviour when using ICT because I know that these rules are to keep me safe.

I know that my use of ICT can be checked and that my parent/carer contacted if a member of school staff is concerned about my Esafety.

We have discussed this with our child who agrees to follow the Esafety rules and to support the safe use of ICT at Bonneygrove Primary School.* Name of parent/carer giving consent* Date*

PARENTAL CONSENT - LOCAL TRIPS

I consent to my child being taken off site within a one mile radius of the school to, for example, a local post box or park etc.

I understand that my child may leave the school premises for local, curriculum-related, regular or routine visits, as may be detailed in the school’s prospectus, or for sports fixtures when representing the establishment as part of a team, and hereby give my consent for my child to participate in such events.

I also understand that my child may leave the school premises at other times when I will be informed separately by letter and when further consent may be required from me.

Whilst on the trip my child can receive medical treatment as necessary. I will inform the school as soon as possible of any change in medical circumstances.

I acknowledge the need for the person named above to behave responsibly and agree to the establishment's procedures in this respect.

I am satisfied that all reasonable care will be taken for the safety and well-being of all participants and that appropriate staffing and safety measures will be in place at all times.

Permission for photographs and/or videos to be taken of my child for use in education or youth work, promotional materials and displays when required, with or without using their name is given.

I give consent to the above* Name of parent/carer giving consent* Date*

A CHECKLIST FOR NURSERY CHILDREN

The aim of this section is to let new parents/carers know of the expectations of the
school and give you helpful information about school routines. We will be happy to discuss any issues
arising from this list with you.

DOES YOUR CHILD KNOW
	Yes	No
Who is picking them up at the end of the day?
When and whether the need for medication for conditions like asthma or serious food allergies should be given?
Where to find their name in their school clothes and plimsolls.

CONSIDERTATIONS FOR PARENTS ONCE THEIR CHILD STARTS SCHOOL
	Yes	No
Would you be able to provide your child with wellington boots that can be left in school.
(Asthma sufferers only) - Have you obtained and labelled a spare inhaler that can be left for your child at school?
Would you be prepared to provide spare underwear for your child?
Can your child identify all their clothes and belongings easily and independently?

EVIDENCE ME - SHARING YOUR CHILD'S SCHOOL DAY

Our Nursery and Reception class teachers can share with parents/carers what their child is doing in school. The 'Parent Share' feature in Evidence Me enables you to view reports (complete with photos) via the app or web suite, showing what your child has been learning and the new skills they are developing, You can send us your comments and feedback by simply adding them to the reports. This will help staff to support your child even more effectively in the classroom. You can also take an active role in contributing to your child's observation portfolio by uploading your own observations, simply add these to the app or web suite.

Once consent is received and your child is attending, you will receive an email from support@2eskimos.com asking you to confirm that you would like to participate. Please check your spam/junk inbox. Participation is optional, but we really recommend getting involved, Please visit http://help.evidence.me/parent-share/help-for-parents/ for further information and guidance.

Name of parent/carer giving consent* Parent/carer email address* Date*

Please provide us with any other information you feel may be necessary to ensure your child’s happiness in school :

The information provided on this form is subject to The General Data Protection Regulation. The information provided is for use by the school, the Local Authority, QCA etc. as identified in the school’s Privacy Notice 2018. It may also be disclosed to the Governing Body and the PTA (Parent/Teacher Association). If you do not wish this information to be discussed to either the Governing Body or the PTA you should notify the school in writing. Should you wish to obtain a copy of the information held by the school relating to you or your child(ren) at any time, you may do so by writing to the school.

	Yes	No
Put on and do up their shoes?
Put on and do up their coat?
Go to the toilet unaided?
Dress him/herself, including tights or trousers?
Recognise their name in writing?