Childcare Centre Registration

e-form

Date

Registration Number (for office use only)

Parents/Guardians must complete all requested information.

Children aged between 3 months and 3 years are eligible to attend our childcare centres. Once children turn 3 years, they become eligible to kindergarten. There are two kindergarten intakes in a year which occur during the first week of February and first week of October. Children who turn 3 years between 1st January and 30th April have to make the transition to Kindergarten in the February intake of that year. Children who turn 3 years between 1st May and 31st December are to move on to Kindergarten in the October intake of that year.

Child's Details

Name

Surname

Date of Birth

ID Card No

Registration for Childcare Services: (choose one of the following)

Parents/Legal Guardians Details

Parent/Legal Guardian 1

Name

Surname

ID Card No

Home Address

Door Name

Door Number

Building Entry Point Name

Street Name

Locality

Post Code

Telephone

Mobile

E-mail

Employed

Self employed

Parent/Legal Guardian 2

Name

Surname

ID Card No

Home Address

Door Name

Door Number

Building Entry Point Name

Street Name

Locality

Post Code

Telephone

Mobile

E-mail

Employed

Self employed

Why do you need this service?

Who has child’s custody?

In case of someone else, who?

Please state whether the child has any health issues

Epilepsy

Eczema

Asthma

Fits

Food Allergies

Other allergies

Other health related problems

Other Persons Contact Details

Contact Person 1

Name

Surname

ID Card No

Relationship to child

Telephone or Mobile Number

Contact Person 2

Name

Surname

ID Card No

Relationship to child

Telephone or Mobile Number

Opening Hours

Childcare centres are open from Monday to Friday between 7:30 am and 4:00 pm.

Please fill in the days you require the service

Day

Monday

Time from

Time to

Day

Tuesday

Time from

Time to

Day

Wednesday

Time from

Time to

Day

Thursday

Time from

Time to

Day

Friday

Time from

Time to

When do you need the service?

Till when do you need the service?

By submitting this application you are giving your permission for the opportune first aid treatment to your child to be administered by qualified staff members. While understanding that you would be contacted by a programme personnel as soon as reasonably possible regarding any emergency involving your child, you are giving your permission for your child to be transported to hospital or any other emergency medical facility in the occurrence of a serious illness or injury, where ambulance or rescue squad members would be authorised to administer all necessary treatments. You are also giving your authorization for warranted health practitioners to examine and provide the necessary emergency medical treatment to your child in your absence.

I declare that the above information is correct and will inform FES immediately of any changes.

FES and agencies/partners collaborating with the FES, may, from time to time, take photos/videos of the children attending the centre to be shared publicly and to promote the service. As required by the Data Protection Act, if you would NOT like to give permission for your child to appear in photos/videos on presentations, social or other media or promotional material, kindly tick this box.

Tick and confirm that you are attaching the following documents with this registration form

A copy of the parents’/guardians’ identity card

Child’s birth certificate (where applicable)

Copy of the child’s immunization record

A copy of the Identity Card/s of authorized person/s to pick up the child.

P3 Statementing of Benefits

Last (3) pay-slips of the eligible parent/guardian who is in work or pursuing studies; or the most
recent tax return and relevant acknowledgement from the Inland Revenue
Department (in case of self employed).

A declaration from the Employer of both the eligible parent/guardian and where applicable the
2nd parent/guardian who is already in employment or in education:
Fixed Schedule: Average number of weekly working hours and the number of days per week.
Flexible Schedule: Average number of monthly working hours and number of days of work per month.

Signature of Parent / Legal Guardian 1

Signature of Parent / Legal Guardian 2

For Office Use Only

Date of Registration at the Childcare Centre

Contribution amount per month

No Contribution

Date of when the Center Coordinator met with Parents/Guardian

Date of when the service started

Date of when the service was terminated

Why was the service terminated?

Signature of Coordinator

Other information that the Foundation may need