| STEPPING STONES MONTESSORI NURSERY
SCHOOL |
| Enrolment Form |
| Name of Child: |
| Home Address including Post Code: |
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| Home Telephone: |
Email: |
| Child's Date of Birth: |
| Mother's Name: |
Mobile: |
| Work Address: |
| Work Telephone No: |
| Father's Name: |
Mobile: |
| Work Address: |
| Work Telephone No: |
| Emergency contact name and number: |
| (Other than parents) relationship to child: |
| Emergency contact name and number: |
| (Other than parents) relationship to child: |
| Doctor's address and telephone number: |
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| Immunisations to date: |
| First Language: |
Religion (if applicable): |
| Known Allergies or special dietary requirements: |
| Details of any medication condition or special needs your child has: |
| Details of any medication that your child is on: |
| Name of school your child is on the waiting list for: |
| Date of
entry into Stepping Stones Montessori Nursery: |
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