Enrolment & Parent Contract

Enrolment & Parent Contract

Step 1: Please complete the form below.
Step 2: Then send a cheque for £250 payable to Clapham Montessori or Clapham Park Montessori to: Clapham & Clapham Park Montessori, The Contact Centre, 60 Hambalt Road, London, SW4 9EA

*This deposit will be returned provided a full terms notice is given, in writing, of your intention to withdraw your child. If a full terms notice is not given, the deposit cheque will be forfeit.

Child's First Name

Child's Surname

Child's Doctor

Doctor's Address

Doctor's Telephone No.

Immunisations your child has received

DiptheriaTetanusWhooping CoughPolioMumpsMeaslesRubella (German Measles)Hib

Details of any medical procedures which are prohibited by family religious beliefs

Details of any special health problems, disabilities or conditions, medication, allergies or dietary restrictions and preferences

Particular requirements relating to a child with special needs

Infections Diseases (Please tick those which your child has ALREADY contracted
MumpsMeaslesRubellaChicken Pox

Additional Emergency Contacts

Name

Contact Number

Name

Contact Number

Names of people authorised to collect your child

Please tick the following boxes as appropriate
In the event of an emergency, I agree to my child receiving medical treatmentI give permission for my child to be taken outside the premises for walks or outingsI give permission for staff to apply antiseptic cream to my child as appropriateI give permission for staff to apply sticking plasters to my child as appropriateI give permission for staff to heat up my child's lunch in the microwave as appropriateI agree to give a full terms notice in writing of my intention to withdraw my child

I accept the offer of a place starting on (insert given date)

I will provide a cheque for £250 (within 7 days of submitting this form), which will be returned to me upon giving a full terms notice, in writing, of my intention to withdraw my child.
Yes

I agree to pay the term's fees within 7 days of receiving an invoice
Yes

Any Other Info

We occasionally take photographs of our classrooms for use on our website. Please tick the box if you do NOT want your child to appear in any photography
I do NOT want my child photographed

Electronic Signature

Date

PDF Form Download

If you would prefer to print out the form, an Application & Enrolment Form in PDF format can be downloaded here >

The hands are the instruments of the mind.

Dr Maria Montessori