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Child’s full name; surname underlined: (wymagane)

Date of birth:


Religion (or N/A):

Language(s) spoken or understood:

Disability/yes or special access requirements (give details):


Telephone number:


Please fix a photo here or email a digital one with child’s name in subject line to

Any allergies or other medical conditions (give details)?

Is immunization schedule up to date?
YesNo (circle one)
History of illnesses:

GP (family doctor) name, address, telephone:

Child’s health visitor name, address, telephone:

Toilet requirements:

Special dietary requirements:

Do you give permission for your child to go on daily outings?
YesNo (circle one)
May we photograph your child when in a group (for internal use only)?
YesNo (circle one)
May we give Calpol for high temperature?
YesNo (circle one)

Name of person(s) with parental responsibility:

HK staff / HK student / non-HK (circle one)

Home address (if different from above):

Home or mobile telephone or both (if different from above):


Work address:

Work telephone:

Emergency contact(s):


Relationship to child



Relationship to child


Password for pick up by anyone not named above (BLOCK LETTERS PLEASE). This will be kept confidential:

I give my consent for my child to receive any medical treatment which is urgently necessary.

Signed (parent/career):


The Happy Kids – Education Centre has a commitment to safeguarding children and promoting their welfare. Any staffs who suspect that a child in their care is suffering any type of abuse has a duty to report this to Social Services.

I am aware of and understand the statement above.

Signed (parent/career):


Regular users only:
Regular start date:

Usage pattern:
Morning session AM 8.00 - 13.00/15hrsAfternoon session PM 13.00 - 18.00/15hrsAll day session 8.00 - 18.00Morning session AM 8.00 - 14.00/30hrsAfternoon session PM 12.00 - 18.00/30hrs

What times and days/ session AM-PM/Full day

you agree Terms & Conditions and Parents Informations

Jeżeli macie Państwo jakiekolwiek pytania to prosimy o kontakt z nami.

Możecie do nas zadzwonić pod numer 01242 230 606, 07884582647, wyslać maila na adres lub skorzystać z formularza poniżej.

Zapraszamy do kontaktu !


Happy Kids, Unit6, Manchester Park,

Tewkesbury Road, GL51 9EJ Cheltenham,

(01242) 230 606, E-mail:

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