Millbank Nursery Schools

07708 085780

Registration Form

About Your Child

If you have more than one child that you would like to attend the nursery, please complete a separate form for each child. Thank you.
Please let us know your child's first name.

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Please let us know your child's last name.

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Please let us know your child's Religion.

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Important Information

Please let us know your child's Primary Language

Please let us know your child's Secondary Language

Medical Information

GP's contact Details

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Including physical impairments and/or learning difficulties. (There will be an additional area to discuss further funding/support your child receives).

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Please confirm if child recieves additional financial or learning support

e.g. social services, GP or health visitor? Or any additional financial support?

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Session Requirements

Click here for more information

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Please let us know which days your child requires at nursery

Contact 1 Details

Please enter Contact 1's First Name

Please provide Contact 1's Last Name

Please provide relationship to child

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You can provide a family password to be given by another person (other than the primary/secondary contact) when picking up your child.

Contact 1 Address

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Contact 2 Details

Please enter Contact 2's First Name

Please provide Contact 2's Last Name

Please provide relationship to child

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You can provide a family password to be given by another person (other than the primary/secondary contact) when picking up your child.

Contact 2 Address

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Please confirm you have read and agreed to our T&Cs

Please confirm who has completed this form