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Registering with us
If you would prefer to receive a brochure and/or registration form by post please
contact us.
REGISTRATION FORM
Please fill out the form below in order to register your place. There is a registration fee of £50 which should be paid by cheque to the nursery in order to secure your place. Once you have filled in the form, we will contact you to confirm your place. :
Child's full name
*
:
Date of birth
*
:
Address
*
:
Post code
*
:
Telephone
*
:
Email
*
:
Parent 1/Guardian's full name
*
:
Day telephone:
Mobile:
Email:
Parent 1/Guardian's
full name:
Day Telephone:
Mobile:
Email:
Alternative contacts who may collect your child, or be telephoned in an emergency
Name:
Day Telephone:
Relationship to child:
Name:
Day Telephone:
Relationship to child:
Name:
Day Telephone:
Relationship to child:
GP Name:
Telephone:
If your child has a severe allergy or medical condition, please let us know below
Please state any special dietary requirements:
Preferred start date:
Preferred sessions
Monday
Tuesday
Wednesday
Thursday
Friday
Morning–8.00am to 1.00pm
Afternoon–1.00pm to 6.00pm
Where did you here about Little Smarties?
If the company you work for entitles you to a discount, please state the company name:
Your Payroll I.D. no:
If you are going to be paying by childcare vouchers, please specify the voucher provider and amount per month you will be paying by vouchers
The voucher provider:
Amount per month:
We encourage you to read and agree to abide by all terms and conditions (copy included), prior to applying to register your child.
We take data security very seriously. As an anti-spam measure, please enter the Security Code from the box below (please note it is case sensitive):
Image Verification
*
:
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