Al Ghadeer Nursery

Child Full Name*

Parent / Guardian Name*

Upload Passport / Identity

Accepted: JPG, PNG, WEBP, PDF, DOC(X), XLS(X). Max 5 MB.

Accepted: PDF, JPG, PNG, WEBP, DOC(X). Max 5 MB.

I have read, understood and accept the Terms & Conditions of Al Ghadeer Nursery.*

confirmed

Signature (typed name)*

Date*

Child Name

For reference — also entered on page 1.

I give permission for the Nursery staff to act in the case of a medical emergency where any delay in getting my signature is considered by a doctor to endanger the child's health and safety.

consented

I agree for my child to be photographed/videoed whilst at Al Ghadeer and for such pictures/videos to be displayed in promoting the provision (paper, social media, and website materials).

consented

I give permission for my child to be given Calpol or similar medication in the case of an emergency.

consented

I give consent for the staff of Al Ghadeer to assist my child in the washroom if required, in terms of washing after toilet use or nappy changing.

consented

I understand that all the information I have provided will be treated as confidential. I also understand that if a matter of safeguarding arises, the Nursery may need to share aspects of information r*

acknowledged

I confirm my consent choices above are accurate and complete.*

confirmed

Signature (typed name)*

Date*

Child Name

For reference — also entered on page 1.

Collector 1 — Full Name*

Person authorised to collect the child (must be over 16).

Collector 1 — Relationship to Child*

Collector 1 — Contact Number*

Collector 2 — Full Name

Collector 2 — Relationship to Child

Collector 2 — Contact Number

Collector 3 — Full Name

Collector 3 — Relationship to Child

Collector 3 — Contact Number

Collector 4 — Full Name

Collector 4 — Relationship to Child

Collector 4 — Contact Number

Signature (typed name)*

Date*