Kidzone Out of School Clubs Limited

Preschool Registration Form

Includes the Parental Agreement, EYPP form and Childcare Contract

Your Account

You’ll use these to sign in to the parent portal.

Email *

Account Password *Confirm Password *

Parent / Guardian Details

Full Name *Contact *Home Address *Work AddressWork Contact

How many children are you registering?

Each child has their own registration form, emergency contacts, doctor, funding, EYPP and Childcare Contract.

Child 1 of 1Child 1

Child’s Details

First Name *Surname *Date of Birth *First Language *Nationality *Password (for collection) *

Health, Allergy & Dietary Information

Please answer each question for this child

1. Does your child have any allergies? *

2. Does your child have any dietary requirements? *

3. Does your child have any food intolerances? *

4. Does your child have any medical conditions? *

5. Does your child take any medication? *

6. Does your child have an emergency/healthcare plan? *

7. Does your child have any additional needs or SEND? *

8. Is there any other health or medical information staff should be aware of? *

9. Is there anything else you would like us to know about your child? *

Parental Agreement

Please select DO or DO NOT for each statement.

1. I DO / DO NOT give Kidzone permission to take my child on trips or walks within the local area, i.e Library, Park etc.

2. I DO / DO NOT give permission for my child’s photo to be taken and displayed within Kidzone.

3. I DO / DO NOT give permission for my child’s photo to be taken and shared on our Kidzone Facebook page.

4. I DO / DO NOT give permission for Kidzone staff to apply sun cream if required during hot weather.

5. I DO / DO NOT give permission for Kidzone to take my child’s photograph for our website or advertising purposes.

6. I DO / DO NOT give permission for Kidzone staff to administer prescribed medication with written consent.

7. I DO / DO NOT give permission for Kidzone staff to administer non prescribed medication such as Calpol and Piriton if and when needed.

8. I DO / DO NOT consent for my child to receive emergency first aid treatment by a first aid qualified member of staff.

9. I DO / DO NOT give permission for a member of staff to accompany my child off site to the hospital for medical assessment / treatment in an emergency.

10. I DO / DO NOT allow staff to apply a plaster to my child as part of first aid if necessary.

11. I DO / DO NOT give permission for Kidzone to liaise and work in partnership with other external agencies both statutory and voluntary (such as health visitor, school teacher’s etc.) to support your child within the setting and give them the best opportunity to thrive.

Contracted Hours

Please enter the total funded or private hours you will be attending per day.

Day	Not attending	Morning 8.45am till 11.45am	Afternoon 12.15pm till 3.15pm	Full Day 8.45am till 3.15pm plus 30 min lunch
Monday
Tuesday
Wednesday
Thursday
Friday

0 days a weekTotal: 0 hours per week

Additional hours charged at £5.75 per hour.

Eligibility CodeEligibility Code for funding

Emergency Contact Details

Emergency Contact 1

Name *Contact *

Address

Emergency Contact 2

Name *Contact *

Address

Doctors Details

Name of Doctor *Contact *

Address *

Funding Eligibility Details

Parent National Insurance Number

Early Years Pupil Premium (EYPP)

The Early Years Pupil Premium (EYPP) is an additional sum of money paid to childcare providers for children who meet the below criteria. Their family gets one of the following:

Income Support
Income-based JSA
Income-based Employment and Support Allowance
Support under Part VI of the Immigration and Asylum Act 1999
The guaranteed element of State Pension Credit
Child Tax Credit, provided they are not also entitled to Working Tax Credit and have an annual gross income of no more than £16,190
Working Tax Credit run-on, which is paid for 4 weeks after they stop qualifying for Working Tax Credit
Universal Credit (household income must be less than £7,400 a year after tax, not including any benefits — this is assessed on up to 3 of the parents’ most recent Universal Credit assessment periods)
They are currently being looked after by a local authority in England and Wales
They have left care through an adoption order, a special guardianship order or a child arrangement order

This funding will be used to enhance the quality of their early years experience by improving the teaching, learning, facilities and resources, with the aim of impacting positively on your child’s progress and development. For more information, please speak to your childcare provider. If you believe that your child may qualify for the EYPP, please provide the following information for the main benefit holder to enable the local authority to confirm eligibility.

I believe Child 1 may qualify for EYPP

Childcare Contract

This contract is between the parent/guardian above and Kidzone Out of School Clubs Limited, the provider, based at Trinity Church, Market St, Farnworth, Bolton, for Child 1.

Terms and Conditions

This contract will start from the date it is signed.

We require 2 weeks’ notice to terminate childcare.

Your contracted days will be payable unless 72 hours’ notice is received to cancel the days.

As per Ofsted requirement, parents or guardians MUST sign their child in and out of Kidzone at all times.

When payments are outstanding, Kidzone reserves the right to terminate childcare with immediate effect until fees are paid. We also reserve the right to discuss the account with anyone that collects your child.

Late Collection

Kidzone charges a late collection fee of £5.00 per fifteen minutes, then £1 per additional minute to cover the cost of staff who have to wait with your child.

I understand if I do not collect my child by the time arranged and Kidzone has been unable to reach me or any of my emergency contacts, we will follow our Uncollected Child Policy.

Kidzone cannot be held responsible for any loss or damage to children’s property.

Future price increases will be notified in writing at least 28 days before any change.

Parents’ Agreement

I consent to my child attending Kidzone Out of School Club.

Kidzone will be legally responsible for my child from when they are signed in until they are signed out.

I will notify Kidzone of any changes to childcare and that if I have not given at least 72 hours’ notice for changes, I understand that these are chargeable.

Information held by Kidzone will be confidential unless there are child protection concerns, and we will deal directly with the relevant authorities.

I confirm the information for Child 1 is correct and I agree to the Childcare Contract terms above.

Parent / Carer Signature

Parent / Carer Signature for Child 1 *

Sign here with your finger or mouse

By signing, you confirm the Registration Form, EYPP form and Childcare Contract above for Child 1. The manager will counter-sign once your details have been checked.