Identification of special requirements does not automatically exclude your child from a place in our provision
Diagnosed Conditions - please select
If you child has to take regular medication, a separate sheet will be required and will need to be updated frequently
My Child has regular medication
Religious or Cultural Practices. Please share any information you think is appropriate
Primary Carer's Work Pattern - If it is irregular
Any other information you feel is relevant. Such as interests, hobbies etc.
At The GAP Centre, the safety of our service users is paramount. Please list the names of people allowed to collect your child. Children will not be released to anyone otherthan those listed unless written consent is given
I confirm that all information provided in the whole of this document is factual and correct at the time of signing. I will inform staff of any changes to this information as soon as possible.
Name
Signed
Date
Optional Research
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Tick all those that apply to your current situation
Child Tax Credit Single Parent
Choose one of the following
Full-Time Education Part-Time Education Education and Training