Milkshake Montessori Nursery

"Education is a natural process carried out by the human individual, and is acquired not by listening to words, but by experiences in the environment."

Discover Milkshake...

You can download our application form (Microsoft Word or PDF format) and after you have completed it you should contact the nursery to arrange a visit, or alternatively, complete the application form using the on-line form below and we will contact you to arrange a visit to the nursery.

Once your application has been accepted your child will be enrolled subject to us having a vacancy.

Please ensure you have read and accepted our Terms, Conditions and Fees.

Your full name:
Childs full name:
Childs Date of Birth (dd/mm/yy):
Childs current address:
Name of Mother:
Address of Mother (if different from childs):
Mothers home telephone:
Mothers work telephone:
Mothers mobile telephone:
Mothers email address:
Name of Father:
Address of Father (if different from childs):
Fathers home telephone:
Fathers work telephone:
Fathers mobile telephone:
Fathers email address:
Who has legal guardianship of child? (Parents must inform in writing if this changes)
Name of Childs Doctor:
Address of Doctor:
Doctors telephone:
Please detail any allergies your child has:
Please detail any diet requirements your child has:
Name of emergency contact (friend or relative):
Relationship to child:
Telephone:
Is there anything else we should know about your child?

Please select the sessions you require for your child:

Start date:
	Full day	Morning	Afternoon	Early Shake	Late Shake	Lunch
Monday
Tuesday
Wednesday
Thursday
Friday

I give permission for the staff at Milkshake Montessori Nursery School all of the following eventualities and activities:

Permission for the staff at Milkshake Montessori to administer First Aid, including the administering of prescribed drugs, in the event of an emergency, provided that the members of staff are suitably qualified. In a emergency , when a parents attendance cannot be immediate, it may be necessary to obtain treatment for a child from a doctor or casualty department/ or in the event of a sudden illness or accident, where emergency treatment, including any operative treatment and/or administration of a general anaesthetic to my child.
We sometimes place pictures of the children in the nursery on our website (www.milkshakemontessori.co.uk). We also take photos for evidence of children's learning, displays and school productions. We need parent's permission for this.
Permission for staff at Milkshake Montessori School to apply a plaster to my child if he/she requires one.
Permission for the staff at Milkshake Montessori to escort him/her on outings by nursery bus/coach/car/ or foot provided that my child is adequately supervised and suitable child restraints are used, where applicable.
Permission for the application of sunscreen lotion/ nappy rash cream, which is to be provided by the parent and labeled with child's name on it. I hereby give confirmation that my child has not suffered any adverse reaction after using this product.
Permission to use the garden Climbing Frame or Loft in Toddler Room. Children will be fully supervised by members of staff at all times. Safeguards are in place, however in the case of any accident, procedures will be in line with our accident policy. (See Policies and Procedures).
The Data Protection Act 1998 All information about children is stored on computer. It is available for you to see at anytime. This information is only available to members of staff at Milkshake Montessori School, Richmond Borough Council and OFSTED.
Permission to give Calpol suspension to my child, should she have a headache or fever.
I have read and accept all terms and conditions of the Milkshake Montessori Nursery School

Milkshake Montessori Nursery Ltd. 131 Warren Road, Whitton. TW2 7DJ.
Tel. 020 8894 3113. Email. enquiries@milkshakemontessori.co.uk