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Ballinrobebrightbeginnings@gmail.com
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About us
Our Ethos
Our Fees
Our Services
Starting Preschool
Our Preschool Curriculum
Our Afterschool
What you need to know
Outdoor Play
Our Team
Contact
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Home
About us
Our Ethos
Our Fees
Our Services
Starting Preschool
Our Preschool Curriculum
Our Afterschool
What you need to know
Outdoor Play
Our Team
Contact
Enrollment
Child’s name:
Home address:
Home phone number:
Gender:
Male
Female
Date of birth:
Date first attended service:
Date ceased attending service:
Mother
Father
Name:
Work address:
Work number:
Mobile number:
Type of Booking:
Monday
Tuesday
Wednesday
Thursday
Friday
Preschool (Free ECCE Year)
9.00 am – 12.00pm – 5 days per week.
9.00 am – 12.00pm – 5 days per week.
Preschool : ( Non ECCE year) Please tick days you would like your child to attend.
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
9.00 am – 12.00
After school: Please write in the boxes the preferred time for your child to attend after school Between 1.40pm- 5.30pm
Name of any other person who may collect the child other than parent/guardian
I authorise
and/or
To collect my child
From Ballinrobe Bright Beginnings in the event of my absence.
Emergency Contact Person:
Name:
Address:
Phone No:
Relationship to Child:
Medical Information:
Details of family Doctor for your child:
Name:
Address:
Phone No:
I/We give permission to contact Doctor in case of illness
Yes
No
Immunisation
Tick
Immunisation
Tick
B.C.G.
B.C.G.
Meningitis C
Meningitis C
6 in 1 ( Polio, whooping cough, HIB, Diphtheria, Tetanus and Hepatitis B)
6 in 1
M.M.R.
M.M.R.
PVC
PVC
Booster
Booster
Has your child had any of the following:
Mumps:
Yes
No
Measles:
Yes
No
Chicken Pox:
Yes
No
Whopping Cough:
Yes
No
Convulsions:
Yes
No
Asthma:
Yes
No
Allergies:
Does your child require additional special needs form?
Yes
No
Is your child on ANY medication?
Yes
No
If yes, please give details:
Permission:
I/ We hereby give my/ our permission for my/ our child to partake in walks and other outings outside the childcare grounds, on the understanding that the adult/ child ratio, as recommended by the insurance company will be adhered to at all times.
Yes
No
I/ We hereby give my/ our permission for my/ our child to be given Calpol or Nurofen when necessary, while in the care of the staff and under the supervision of the manager. (Only in an emergency and parents cannot be contacted.)
Yes
No
I/ We hereby give my/ our permission for staff to apply sun cream to my/ our child if staff feels it is necessary.
Yes
No
I/ We give permission for my/ our child to be administered first aid in case of emergency, on the understanding that it would be administered by a fully trained staff member.
Yes
No
