Contact Details

It is important that we always have up to date emergency contact details for your child so we will be periodically be sending out this form. However, if at any time your contact details change, please could you inform Wendy Presland the Business Manager, in writing, to enable us to have up to date information at all times.

To ensure we have the correct details for your child, please can you complete and return this form by Friday 18th January 2013.

Child's Name

DOB

Home Address

Postcode

Home Telephone No

Emergency Contact Details

Name

Tel No

Relationship to Child

Name

Tel No

Relationship to Child

Name

Tel No

Relationship to Child

Allergies

Does your child have any allergy?

Yes

No

If yes, please advise

Does your child have any dietary requirements?

Yes

No

If yes, please advise

Change Requested By

Date

Relationship to child