Jumping Jacks Childcare — Parent Registration Preview

1. Child details

Child’s full name Date of birth School / year group Parent or carer name Emergency contact number Date completed

2. What applies to your child?

Tick all that apply.

No known allergy, intolerance or special dietary requirement Coeliac disease or another medically required special diet Diagnosed allergy (food, medicine, insect sting, latex/contact or other) Religious, cultural or ethical dietary requirement Suspected allergy / awaiting assessment Sensory need, food aversion, dislike or preference Food intolerance or sensitivity (e.g. lactose intolerance)

Important: An allergy can be serious or life-threatening. Intolerance is different and does not cause anaphylaxis. Coeliac disease is a medical dietary need.

3. Tell us about the need

Allergen, food, substance or dietary need What must be avoided? What happens? Please describe any symptoms or reaction Safe alternatives or foods allowed

Is there a cross-contact risk?YesNo

Should foods labelled “may contain” be avoided?YesNo

4. Healthcare information & medication

Tick all that apply.

Diagnosed / confirmed by a healthcare professional Awaiting GP, allergy, paediatric or dietetic assessment Healthcare advice received, but no formal diagnosis Parent/carer report only at present

Healthcare professional or service (if applicable)

Which medication should be kept at the setting?

If other, please specify

Have you provided a separate clinical allergy action plan?YesNo

Add the action plan (if you have one)

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Emergency treatment or what staff should do

5. Parent declaration

I confirm this information is accurate and I will tell Jumping Jacks straight away if anything changes.

Parent or carer’s full name Date

We will review this information at least once a year and whenever your child’s needs change.

Let’s get started

Your family account

Tasks to complete

Parent account

Make a permanent booking

Your booked sessions

Book an ad hoc session

Photo and video permission

Allergy, intolerance & dietary needs

1. Child details

2. What applies to your child?

3. Tell us about the need

4. Healthcare information & medication

5. Parent declaration

Getting to know how we can support your child

About your child

What would help us?

Parent or carer confirmation

Jumping Jacks policies

Preschool funding details

Choose your child’s start date