First Name:

Date of Birth:

   Male   Female

First Name :

Mr. Mrs. Ms.

Address:

How did you hear of us? (source) :

( e.g Friends, Local papers, LEA etc. )

Telephone No:
(Daytime)

   Evening :

Emergency Contact
Tel No1:

  Tel No2 :

Session Requirements

IF YOUR CHILD IS 3+, PLEASE INCLUDE AT LEAST TWO FULL DAYS.
KINDLY DISCUSS ANY SESSION REQUIREMENTS WITH PRE-SCHOOL OFFICE FIRST 020 8933 7422

Child's Medical Details

Child's Medical Details:
( If none Please write none)

Any Allergies:

Any Disabilities :

Other:

Family Doctor:

Address:

Telephone No:

School Details:

Date of entry into Infant School (if known)

Name of School :

• I understand I am responsible for payment of all sessions booked during term time.
• I have read the terms and conditions of registration attached.
• I agree to give one term (12 weeks) written notice of my child’s withdrawal at any time from the Pre-School after commencement. Failure to do so will lead to forfeit of deposit paid.
• I understand when my child turns the age of THREE, he/she will automatically be staying to 12:25pm unless I choose for full day option to 3pm.
• I agree to pay uniform charges of £18 for a set of polo tee shirt and Sweat shirt which will be billed in the fee statements subsequently
• I enclose a non-refundable registration fee of £15 and a returnable deposit of £100 to secure a place for my child at the earliest date available for commencements.

Registration Fee £15.00 (non-refundable)

Thank you for choosing Little Stars Pre-School