DC Form-Reception 2023 1. PUPIL INFORMATION FIRST NAME * MIDDLE NAME (if any) LAST NAME * PREFERRED NAME (if any) GENDER * Girl Boy DATE OF BIRTH * Home Address (including postcode) YEAR GROUP/CLASS * Nursery Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 DID YOUR CHILD ATTEND SPRING GROVE NURSERY? * Yes No 2. CONTACT DETAILS We will use this information as your main contact details. MAIN CONTACT NUMBER * MAIN E-MAIL * 3. FAMILY CONTACT DETAILS 3.1 PARENT/CARER RELATIOSHIP TO THE CHILD * Mother Father Step Parent Guardian Other Family Member (siblings,relative) Other RELATIOSHIP TO THE CHILD NAME * E-MAIL * MAIN CONTACT NUMBER * ADDITIONAL NUMBER(S) Address if different from Section 1(including postcode) 3.2 PARENT/CARER RELATIONSHIP TO THE CHILD * Mother Father Step Parent Guardian Other Family Member (siblings,relatives) Other RELATIONSHIP TO THE CHILD NAME * E-MAIL * MAIN CONTACT NUMBER * ADDITIONAL NUMBER(S) Address if different from Section 1(including postcode) 3.3 EMERGENCY CONTACT We must have a third emergency contact, it must be someone other than the persons listed above. NAME * CONTACT NUMBER * RELATIONSHIP TO THE CHILD * Step Parent Other Family Member (siblings,relatives) Other RELATIONSHIP TO THE CHILD ADDITIONAL NUMBER(S) 4. SIBLINGS AT SPRING GROVE Does your child have any siblings at Spring Grove? * Yes No - Go to Section 5 Sibling details Sibling Name * Class (Current) * Reception Year 1 Year 2 Year 3 - Apple Year 3 - Lime Year 4 Year 5 Year 6 Add Remove If you are human, leave this field blank. Next Δ
