Application Form

Please note that we are only open during school term time. From the term after their 2nd birthday some children are eligible for 15 hours Free Early Learning (FEL). Please see a member of staff for details.

Breakfast Club
8:00am - 9:00am
Core Morning
9:00am - 11:30am
11:30am - 1:00pm
Core Afternoon
1:00pm - 3:30pm
Tea Club
3:30pm - 5:00pm
Black or Black British
Mixed/Dual Background
Asian or British Asian
Any other background
Place of Birth
Home Language
Doctor's Name and Contact Details
Please give details of any health issues we should know about
Please give details of any additional needs or development concerns that we should know about
Please give details of any services offering support to your family
In an emergency where urgent medical attention is needed and I cannot be contacted to authorise this, I hereby give me general consent to any necessary medical treatment and authorise Nursery to sign any document required by the hospital authorities. For less urgent medical treatment, where an ambulance is not required, I understand that staff cars (fully insured) may be used to take my child to the A&E department of Sheffield Children's Hospital.
Photographs and Video
To record your child's learning as part of their progress record which will be passed on to their infant/primary school when the leave Broomhall Nursery
For use in displays in nursery
For use on our promotional literature e.g. posters and leaflets
For use on our website, Facebook page and Twitter feed.
On occasions Press and TV journalists may wish to take photographs and/or record video footage of special events at nursery during which time your child may be included
Students from Sheffield Universities (DBS checked) undertake observational research projects in nursery. Individual children are not identified in the findings of the research
Does your child attend any other nursery/childcare provision?
Parent/Carer Full Name:
Thank you! Your application has been received!
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