Holiday Club creche Registration Form 2019

space academy logo mediumDear Parent

Please can you fill out the form below to register your child/ren for the Holiday Club Creche, one form per child please.  We want to make the creche a fun, happy and safe place for all the children, and the lovely volunteers running it, so any information that will help with that will be really useful.

Child's First Name: 

Child's Surname: 

Child's Date of Birth: 

Any Special Needs?  
e.g. allergies, medical conditions, medications: 

(If yes, please specify): 


Is your child toilet trained?: 


If yes, please specify how much help your child needs to use the toilet: 


Is there anything helpful for us to know about your child's temperament, nature, ability to interact with others?: 


What toys and activities does your child enjoy?: 

Any other information?  
Which days will they be attending?
(Choose all that apply)
Mon AM > < Mon PM
Tue AM > < Tue PM
Wed AM > < Wed PM
Thur AM > < Thur PM
Fri AM > < Fri PM   

Parent's Name: 







Email Address: 



Melanie Shields, 04/06/2019