Child *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender

Girl

Boy

Other / prefer not to say

Sessions

Select which sessions you would like to book for your child. These are subject to availability. If you would like to book additional sessions, either before or after school times, or on other days, please also complete the Little Earth Nursery application form.

Nursery 1 - Mondays, Tuesdays and Wednesday mornings

Nursery 2 - Wednesday afternoons, Thursdays and Fridays

Either / don't mind

Lunchtime *

There is a £3.25 charge for a supervised mid-day session which includes hot school lunch, unless you choose to pick up your child between 11.50am and 12.10pm.

My child will have a school lunch.

I will take my child home for lunch.

Do you wish to book additional Little Earth sessions alongside the school nursery place? *

These can be funded for those families entitled to 30 hours childcare, or may be paid for.

Yes

No

Not sure

Parent/Carer's Name *

First Name

Last Name