Consent Form - Twizzle Tops Day Nurseries Twizzle Tops Day Nurseries

Child Details

Select your Nursery(Required)

Child's Full Name(Required)

Child's Date of Birth(Required)

Consent Information

I give consent for my child to have face paint applied at Twizzle Tops nursery.(Required)

Yes
No

I give consent for my child to go on a bus during an outing with Twizzle Tops nursery.(Required)

Yes
No

I give consent for my child to have an adhesive dressing applied by a Twizzle Tops staff member.(Required)

Yes
No

I give consent for a member of Twizzle Tops staff to administer Paracetamol when required.(Required)

Yes
No

I give consent in the event of illness, accident or emergency we will act on your behalf and take such action as we consider appropriate.(Required)

Yes
No

I give consent for the nursery to contact 111 or 999 if they are unable to contact myself or nominated emergency contacts for written consent.(Required)

Yes
No

I give consent if my child is on any medication for a member of Twizzle Tops staff to administer when required.(Required)

Yes
No

I agree that for the health and welfare of all children who come to the nursery I will not bring my child into nursery if they are ill or have an infectious disease.(Required)

Yes
No

I agree that for the health and welfare of all children who come to the nursery I will not bring my child into nursery if they are showing symptoms of Covid-19 until they receive a negative test.(Required)

Yes
No

I give consent for a member of Twizzle Tops staff to apply nappy cream, that has been supplied by myself, to my child when required.(Required)

Yes
No

I give consent for a member of Twizzle Tops staff to apply our nursery sun cream to my child when required.(Required)

Yes
No

I give consent for Twizzle Tops staff to take my child on local walks in the community.(Required)

Yes
No

Declaration

I confirm that the information provided in this form is correct to the best of my knowledge and I will keep the nursery informed of any changes information.

Full Name(Required)

Date(Required)