New Starter Form – Walthamstow Montessori School

This form must be completed at least two weeks before your child starts at Walthamstow Montessori School.

The form requires photos and signatures of parents / guardians and any other people who are likely to collect your child from school.

(If it takes a while to gather all the information required, you can save the form in progress using the Save & Continue button at the bottom. You will be given a temporary link in order to re-access your form in progress.)

Please also read / download the WMS Terms and Conditions. Your acceptance of these are a condition of the new starter form.

Child's Details

Family name / surname(Required)

Given name(s) / forename(s)(Required)

Gender(Required)

Home address(Required)

Date of birth(Required)

DD slash MM slash YYYY

Ethnicity(Required)

Religion(Required)

First language(Required)

Other language(s)(Required)

Access / equipment requirements

Special requirements

Does your child attend or has previously attended any other educational setting?(Required)

Yes

Name and location of setting

Does your child have an EHCP (Education, Health and Care Plan) or is one in progress?(Required)

Yes

Please give EHCP details

Are you working with any professionals such as speech and language therapists, educational psychologists and behaviour management therapists?(Required)

Yes

Please give details about the therapy

Parent / Guardian 1 Details

Family name / surname(Required)

Given name(s) / forename(s)(Required)

Relationship to child(Required)

Home address (if different from child's)

Email(Required)

Mobile number(Required)

Work number

Home number

Parent / Guardian 2 Details

Family name / surname(Required)

Given name(s) / forename(s)(Required)

Relationship to child(Required)

Home address (if different from child's)

Email(Required)

Mobile number(Required)

Work number

Home number

Emergency Contact

Please give the contact name and number of a 3rd party whom we may contact if we can’t get hold of either parent / guardian in the event of an emergency

Emergency contact name(Required)

Emergency contact number(Required)

People authorised to collect Child from school

IMPORTANT: For security and legal reasons, collection may only be made by authorised people whose photos and signatures we hold on file, including both Parents / Guardians. On this form you can also authorise 2 other collectors such as relatives and childminders.

Collection password(Required)

Who will be the main collector?(Required)

Is Parent / Guardian 1 authorised to collect Child from school?(Required)

Yes

Parent / Guardian 1 Photo(Required)

Max. file size: 50 MB.

Parent / Guardian 1 signature(Required)

Is Parent / Guardian 2 authorised to collect Child from school?(Required)

Yes

Parent / Guardian 2 Photo(Required)

Max. file size: 50 MB.

Parent / Guardian 2 signature(Required)

Additional Collector 1 name

Collector 1 relationship to Child

Collector 1 phone and email

Collector 1 photo

Max. file size: 50 MB.

Collector 1 signature

Additional Collector 2 name

Collector 2 relationship to child

Collector 2 phone and email

Collector 2 photo

Max. file size: 50 MB.

Collector 2 signature

Food Allergies and Preferences

Is your Child allergic to or intolerant of any foods?(Required)

Yes

Please specify if your Child MUST NOT BE GIVEN any of the following:

Dairy products / milk / lactose

Egg

Peanuts

Tree nuts

Fish

Shellfish

Soy

Gluten (wheat, rye, barley, etc)

Sesame

Mustard

Celery

Lupin

Sulfites

Any other allergen / food intolerances not listed above

Below are a list of foods that we often offer to the children. Please TICK EACH FOOD you give permission for your Child to eat. Note that we work on the basis of permission – you may not specify “sometimes” or “in moderation” for individual foods.

I give permission for my Child to eat:

Milk

Water

Bread (sliced)

Bread (pitta or flatbread)

Margarine

Dairy free spread

Rice cakes

Crispbreads

Bread sticks

Jam

Marmite

Honey

Marmalade

Chocolate spread

Cream cheese

Biscuits

Birthday cake

Raisins

Dried apricots

Apples

Bananas

Pears

Pineapple

Strawberries

Grapes

Oranges

Lemons / limes

Celery

Tomatoes

Cucumber

Carrots

Other foods – comment

Here you can add detail about any foods that your Child is NOT permitted to eat, including foods that are not listed above.

Photography and Other Permissions

We take photographs of children in the school setting to support and evidence their learning as set out in the WMS Terms & Conditions.

We also take photographs for use in the weekly WMS newsletter and sometimes for use on the WMS website and social media accounts such as Instagram.

Please tick “yes” to confirm your preferences / authority in this regard below. If “no”. please leave blank.

I confirm that

Photos of my child may be used in the WMS newsletter

Photos of my child may be used in the WMS website

Photos of my child may be used on the WMS Instagram and Facebook accounts

I consent to my child having their hair checked for head lice

I consent to my child having their face painted

I consent to WMS applying plasters to my child should they suffere a cut or similar

Health Information

Doctor's Name(Required)

Doctor's Address(Required)

Health Visitor Name

Vaccinations Given(Required)

MMR (3 in 1)

Measles

Mumps

Rubella

Hib

Polio

Tetanus

Diptheria

Meningitis C

NONE GIVEN

History of any allergic reactions

Past illnesses

Chicken pox

Mumps

Rubella (German measles)

Scarlet fever

Convulsions / fits

Nose bleeds

Additional medical information, diagnoses or medical investigations underway

Potty Training Information

Please inform us if your child is not yet potty-trained, and please keep us informed of progress at home in this regards.

Please replace nappies, pull-ups or underwear daily in your child’s drawstring bag with their name on the outside.

Is your child potty trained?(Required)

Yes

Partially

Uses child loo seat?

Yes

Sometimes

Wears nappies?

All the time

At night

Outside of home

Other helpful information about toileting

Sleep and Rest Information

Does your child nap regularly?

Duration of naps

Times and specific routines

Comfort items (e.g. pacifier)

Settling-In and Special Interests

Child's particular interests

Preferred activities

Favourite songs / rhymes

Snack preferences

Drink preferences

Child self-feeds

Names by which child refers to their parents

Other helpful information

Parent / Guardian Declaration

I confirm that the information provided above is accurate and complete to the best of my knowledge:

Parent / Guardian 1 Name(Required)

Parent / Guardian 1 Signature(Required)

Parent / Guardian 2 Name(Required)

Parent / Guardian 2 Signature(Required)

Consent(Required)

I / we agree to the WMS Terms and Conditions

Date(Required)

DD slash MM slash YYYY