Registration Form for Basecamp Alderwood

Student first name: *

Student surname: *

D.O.B: *

Age:

Preferred name:

Describe Gender:

Student's gender: *

Male

Female

Prefer to self-describe

Child’s Current School:

Class Name:

Year:

Address:

267 Halfway Street, Sidcup Kent, DA15 8DP

Post code:

Language(s) spoken:

Is English your child's first language?:

Primary contact first name: *

Surname: *

Relationship:

Address: *

267 Halfway Street, Sidcup Kent, DA15 8DP

Contact number: *

Work number:

Email address: *

Occupation:

Are there any other contact restrictions?:

Yes

Details:

Option 7 (for Secondry)

Secondary contact first name:

Surname:

Relationship:

Address:

Contact number:

Work number:

Email address:

Occupation:

Custody of the child is with:

Primary contact

Secondary contact

Both (joint custody)

Other

Contact no.1 name:

Relationship:

Address:

267 Halfway Street
Sidcup 
Kent 
DA15 8DP

Mobile number:

Work number:

Contact No.2 name:

Relationship:

Address:

267 Halfway Street
Sidcup
Kent 
DA15 8DP

Mobile number:

Work number:

I, hereby consent and grant permission to the following persons to collect my child (Must be 18 years or over):

I give consent for Sheniece and Sabrena to collect Tavian from ASC in the event me or his dad are unable to. 
No password is needed as Tavian will be able to identify both :)

Allergic reactions - Severity: *

Not Applicable

Very high

High

Medium

Low

Allergies, if any:

Medical conditions, if any:

Does your child have any dietary requirements?:

Yes

Special needs:

Does your child have any special educational needs (SEN)?:

Yes

If your child has any learning difficulties/disabilities or requires additional assistance, please list them here:

?Adhd
? Autism

Any other relevant information we may need to be aware of ?:

Tavian can be a bit of a bland eater. At school he is encouraged to eat a wider range of food due to his peers, but if you could keep this going (as his previous after school club Alpha has been making amazing progress with him) and I'd really like for this to continue.

Please read our Terms & Conditions View T&C's

Any other instructions :

Early registration is recommended. Registrations will be considered in the order in which they are received. This form must be signed by the parent(s)/ guardian(s) with parental responsibility; applying for admission of the named child and who it is assumed will be responsible for the fees. For more details, please visit our website: https://basecampchildcare.co.uk/.

Declaration :

I accept the terms and conditions of Basecamp Childcare.

Yes No

Full Name of Parent/Carer:

Digital Signature

Stacey

Date & time:

08, Jul 2025 10:04 am

BasecampAlderwood

Profile

Contacts

Emergency

Health

Other

Consents

Terms