Personal Information and PermissionsPersonal Information and Permissions SomertonChild’s Full name Email address I can contact you onChild’s Address Date Of BirthHome Language Password for Collection (Where applicable) Adults With Parental Responsibility NameAddress (if different from child)Relationship to Child Name Address (if different from child)Relationship to Child Emergency Contact Numbers1st Contacts NameAddress Relationship to Child Contact Number 2nd Contacts NameAddress Relationship to Child Contact Number Does Your Child Have Any Known Allergies Yes No If So Please Give Full Details Does Your Child Have Any Special Dietary Requirements Yes No If So Please Give Full Details Does Your Child Have Any Known Medical Conditions Yes No If So Please Give Full Details Is Your Child Up To Date With Their NHS Vaccinations Yes No If No Please Give Details Childs GP Please Fill In With The Childs GP Name Address And Contact Number Permissions SectionPlease Tick Each Box Below To Give Your Consent Complaints I have been given/sent a copy of the complaints policy and know how to contact should I have a formal complaint that cannot be resolved between ourselves I have been given/sent a copy of Safeguarding and Child Protection Policy and understand that childminders are bound by a legal duty to report any concerns about child’s welfare or safety Accidents and Emergencies I give permission for my child to receive basic first aid within the setting when necessary. I understand that I will see a copy of the accident/ incident reports involving my child, which i must sign and date I give permission for plasters to be used on my child , where nescessary. I give permission for my child to be taken to the accident and emergency department (A&E) for urgent medical attention if this is necessary and I cannot collect them immediately Physical Contact I give permission for my child to have sun cream reapplied on hot days I give permission for wet wipes to be used on my childOff-Site Journeys I give permission for my child to go for a local walk Outdoor Play I give permission for my child to use large outdoor equipment in the setting and purpose-built playground Photographs and Observations I agree that any photographs sent to me showing other children in the setting will be for personal use only by parents/carers. They will, under no circumstances, be shared on social media or sent to anybody else outside the setting Please tick below to say how photographs of your child may or may not be used: To be sent to me via email/private group/on paper to be shared in group messages which can be seen by other parents from the setting to be seen in the background of photographs taken of other children and sent to their parents/carers to be used in a portfolio which will be kept in the setting and viewed by children prospective parents and Ofsted to be used freely on my business website/social media pages as advertising for the setting to be used on my business website/social media pages as advertising for the setting – Only when my child’s face is blurred or hidden Childcare Practitioner’s NameChildcare Practitioner’s SignatureDate Signed Parent/Carer’s NameParent/Carer’s SignatureDate Signed Date Policy Written Review Date Submit Form
