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Child's Full Name
Date of Birth
Please inform us of any additional information that we may benefit from knowing whilst your child is in our care. (Include any medical information/allergies in this section.)
If you would like us to contact you to arrange to produce a ‘one page profile’ to highlight any additional needs please tick this box.
Alternative/Emergency Contact Name
Relationship to Child
I give permission for my child to:
Be provided with juice
Be provided with biscuits
Be photographed for use in JCL social media and other promotional material
Be transported in line with our Safeguarding Policy
Does your child need assistance with using the toilet? (Tick for Yes)
Is your child wearing nappies? (Tick for Yes)
Thanks for submitting!
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