Home The Filthy Squirrel Way Join the Filthy Squirrel Family Nursery Registration and Consent Form Waiting List Camp Squirrel Holiday club registration form Policies Order Number Child's name * Address * Date of Birth * Gender * Male Female Name of parent or guardian (Main contact) * Email Address * Contact Number * Relationship to child * Address Same as child different Address if different Second Contact Name * Email Address * Contact Number * Relationship to child * Address Same as child different Address if different Doctor’s Name * Surgery Address Surgery Phone Number * Does the child have any medication conditions, disabilities, additional support needs or receive regular medication? Yes No If yes, please give details. I declare my child physically fit to participate at Filthy Squirrels Woodland Nursery activities. I understand that there is an element of risk and I accept that. In the case of an incident, I give permission for First Aiders to treat my child. In the event of any change I will inform Filthy Squirrels. * Yes, I give my permission No I don't give permission I accept that personal belongings are not covered by Filthy Squirrels insurance and that Filthy Squirrels will not be held responsible for damage to, or loss of these items. * I accept Photos and videos are taken during our sessions. These are used for assessing, evaluation and monitoring processes. At times, they may also be used in our marketing, publicity and website including social media. I give permission for these photos to be used in marketing and social media. * I give my permission I don't give my permission The information on this form is covered by the ICO and will be entered onto our computer for the purpose of Filthy Squirrels Administration only. Parent Signature The information on this form is covered by the ICO and will be entered onto our computer for the purpose of Filthy Squirrels Administration only. Find all of our policies here * Name Date I consent to my personal email being added to the Filthy Squirrels Mailing List. This will be used to provide you with information. At no time will your email be given, sold or passed to a 3rd party without consent. * I consent The Threshing Barn, Unit 8, Fifield Bavant, Wiltshire, SP5 5HT Name Email Address Message 3 + 9 = Submit
