Award Winners  
 
  
 
 
Registration Form
 
Please print and complete the registration form.
Completed forms, along with fees should be sent to Windmills Nursery School.
Cheques should be made payable to 'Windmills Nursery School'
 
Address and Contact Information
Childs Name     Date of Birth  
         
Address  
Postcode     Telephone  
         
Mothers Name     Daytime Tel  
Fathers Name     Daytime Tel  
Urgent Contact     Contact Tel  
 
Sessions of Attendance Required Please Tick (Minimum of Two)
 
Monday
Tuesday
Wednesday
Thursday
Friday
Morning          
Lunch          
Afternoon          
         
Commencing Day Month Year
Paying Fees By Month (tick Here)
or
 By Term (Tick Here)
     
Does your child attend any other Nursery or pre-school?  
If YES please give further information.  
 
Medical Details
Doctors name     Telephone  
Doctors Address  
         
Has your child been fully immunised, including tetanus?  
Does your child have any known allergies?  
If YES please give further information.  
Does your child have a history of, or any current medical conditions or requirements
that the Nursery should be aware of?  
 
Dietry Requirements
Are there any requirements that the Nursery should be aware of?  
If YES please give further information.  
At breaktime would your child prefer milk, squash or water?  
 
Cultural and Religious Background.
Religion.  
 
Emergency Medical Treatment
By signing below, I give my consent for my child to be given emergency treatment in the event that I cannot be contacted in the case of an accident or emergency.
Signed
    Print Name  
 
Local Outings
By signing below, I give my consent for my child to be taken on short outings within Harbury village.
Signed
    Print Name  
 
Photographs
By signing below, I give my consent for my childs photograph to be used in local articles, and understand that only first names will be used.
Signed
    Print Name  
 
Other Information
Have you any other comments or information that you feel would be useful to the nursery?

 

 
Please give the names of all people other than yourselves, authorised to collect your child from the nursery.

 

 
By signing below, I give my consent for my childs photograph to be used in local articles, and understand that only first names will be used.
Signed
    Print Name  
 
Declaration
Please read the following declaration before signing this form.
I understand that fees are payable at the begininning of each month or term. Fees are payable even in the event of a child not attending due to illness or holidays. A minimum od 1 months written notice to leave is required and fees are payable for this notice period. A minimum of two months written notice is required if your child is not going to commence on the agreed date. We reserve the right to review fees annually.
Signed     Print Name  
Date
    Mother/Father?  
 
Payments        
Value of cheque attached, including the £35 Administration fee. £
Please make cheques payable to 'Windmills Nursery' - thank you.
 
Nursery Mobile: 07906 519148
C/O Harbury Primary School, Mill Street, Back Lane, Harbury, CV33 9HR.