Visions Children's Centre - Family Registration Form

Register With us

Sessions are FREE to all registered parents/carers of children aged 0-5 years living in Rutland.

Complete the forms below to register online!

Or download a copy to complete at home here

This form must be completed by the parent/carer who has parental responsibility for the child/children shown. If another member of the family (i.e. Grandparents etc) will be bringing the child to session then they must also register with the Children's Centre.

If you would like any help filling in the form then please speak to a member of staff from the Children's Centre.

The Children's Centres Registration Form

Complete this online form to register for free access to Children's Centre groups, courses, activities and services. Venues include Oakham, Uppingham, Kendrew Barracks Cottesmore and St George's Barracks Edith Weston.

This section is about you, the main carer: Title

Full Legal Name

Gender

Date of Birth

Relationship to Child

Marital Status

Address

Postcode

Home Telephone

Mobile

Email Address

Name and address of the Doctor's Surgery you attend

Do you smoke?

If YES, would you like help to give up?

Are you a lone parent?

Are you expecting a baby?

If YES, due date

Do you have diagnosed disabilities or specific needs?

If YES, please give details

Work Status

Benefits you are currently receiving. E.g. None, Child Benefit, Income Support, Jobseekers Allowance, Child Tax Credit, Working Tax Credit, Carers Allowance, Disability Living Allowance

Ethnicity

If OTHER, please specify...

Country of Birth

First Spoken Language

Level of English Spoken

This section is about your partner or child/ren's other main carer: Title

Partner/Other main carer's: Full Legal Name

Partner/Other main carer's: Gender

Partner/Other main carer's: Date of Birth

Partner/Other main carer's: Relationship to Child

Partner/Other main carer's: Marital Status

Partner/Other main carer's: Address

Partner/Other main carer's: Postcode

Partner/Other main carer's: Home Telephone

Partner/Other main carer's: Mobile

Partner/Other main carer's: Email Address

Partner/Other main carer's: Name and address of the Doctor's Surgery they attend

Partner/Other main carer: Do they smoke?

If YES, would they like help to give up?

Partner/Other main carer: Are they expecting a baby?

If YES, Partner/Other main carer's due date:

Partner/Other main carer: Do they have any diagnosed disabilities or specific needs?

Partner/Other main carer: If YES, please give details

Partner/Other main carer's: Work Status

Benefits your Partner/Other main carer is currently receiving. E.g. None, Child Benefit, Income Support, Jobseekers Allowance, Child Tax Credit, Working Tax Credit, Carers Allowance, Disability Living Allowance

Partner/Other main carer's: Ethnicity

Partner/Other main carer's: If OTHER, please specify

Partner/Other main carer's: Country of Birth

Partner/Other main carer's: Level of English Spoken

This section is about your children - Child 1: Legal First Name(s)

Child 1: Legal Surname

Child 1: Address

Child 1: Postcode

Child 1: Date of Birth

Child 1: Gender

Child 1: Location of Birth

Child 1: Does this child have any diagnosed disabilities/specific needs?

Child 1: If YES, please specify

Child 1: Ethnicity

Child 1: Ethnicity: If OTHER, please specify

Child 1: Any other information (allergies etc)

Child 1: Does this child attend a Nursery setting/Childminder?

Child 1: If YES, please state name

Child 2: Legal First Name(s)

Child 2: Legal Surname

Child 2: Address

Child 2: Postcode

Child 2: Date of Birth

Child 2: Gender

Child 2: Location of Birth

Child 2: Does this child have any diagnosed disabilities/specific needs?

Child 2: If YES, please specify

Child 2: Ethnicity

Child 2: If OTHER, please specify

Child 2: Any other information (allergies etc)

Child 2: Does this child attend a Nursery setting/Childminder?

Would you be interested in Volunteering within the Children's Centre or within our Early Help service?

Would you like more information about becoming a Parent Champion?

IT IS IMPORTANT THAT YOU READ THE FOLLOWING AND COMPLETE BELOW: The information recorded in this form will be used to enable staff to offer appropriate support and for monitoring and evaluation purposes.

The information will be kept in accordance with the Data Protection Act 1988. We shall keep records confidential and share only with authorised persons and professionals...

...working in partnership with us, these include local authorities, schools, health partners, Job Centre Plus, Early Years' Providers, the voluntary and community sector and the Department of Education.

We are legally obliged to share this information with other agencies if there are safety concerns about you or your children.

You have the right to access any information we hold on you or your family and can request the details to be removed from the system at any time.

PLEASE SELECT 'I agree' IF YOU AGREE WITH THE FOLLOWING STATEMENT: On submitting this document/form, I understand that my family will be registered with The Children's Centre.

GDPR: IT IS IMPORTANT THAT YOU READ THE FOLLOWING AND SIGN BELOW. Please answer Yes/No to the following: I consent to my family's details being held on The Children's Centre database.

I give permission for photographic images to be taken of me and my child.

If yes, please answer permissions for the following medias: The Children's Centre promotional displays throughout Rutland

The Children's Centre promotional marketing e.g. newspapers and leaflets

The Children's Centre Website/Visions Children's Centre Facebook page

I would like to be added to the Children's Centre Parent Mail system and receive information on groups/activities and services that may be of interest to me and my family.

This form must be signed by a parent/carer who has parental responsibility for the child/children detailed. Please enter your name in the box below to sign.

The Children's Centre receives live birth data on a monthly basis from Leicestershire and Rutland trust but we need consent to register (the children) with The Children's Centre.

Should you have any subsequent children while living in Rutland, do you consent to us automatically registering the child? Consent can be withdrawn at any time by contacting familyhub@rutland.gov.uk

Data Protection and General Data Protection Regulation (GDPR) Information

In order to comply with the Data Protection Act and the General Data Protection Regulation (GDPR), we have to provide you with information about the personal data you give us. The information is set out below:
Rutland County Council is the data controller for the personal information you may provide. You can contact them by phone on 01572 722577, via email to dataprotection@rutland.gov.uk or by writing to them at Data Protection, Catmose House, Oakham, Rutland, LE15 6HP. Your information will be used to:

Enable Children's Centre staff offer the appropriate family support when requested.
Collating and producing statistical information on families who use the Children's Centre services (numerical information only).
Evaluation of services provided by Visions Children's Centre.
Identifying families with children of a specified age, for future services/events.
Identifying families who may be interested in claiming 2 Year Early Eduction funding.

We shall keep records confidential and share only with authorised persons and other professionals working in partnership with us. These include local authorities, schools, health partners, Job Centre Plus, Early Years providers, the voluntary and community sector and the Department of Education. We are legally obliged to share information with other agencies if there are safety concerns about you or your children.

We will only retain your personal data for us as long as necessary to fulfil the purpose we collect it for, including reporting requirements.

You have the following rights under GDPR. Please note not all of these rights apply to all processing. Further details on each right can be found on the RCC website: https://www.rutland.gov.uk

The right to be informed
The right of access
The right of rectification
The right to erasure
The right to restrict processing
The right to data portability
The right to object.
Rights related to automated decisions making, including profiling.

You are responsible for ensuring that the Personal Information we hold about you is up to date and accurate. If your Personal Information changes, please let us know if you want us to update or correct it by writing to us at:

The Children's Centre, Catmos Street, Oakham, Rutland, LE15 6HW

or via here.

Register With us

The Children's Centres Registration Form

Data Protection and General Data Protection Regulation (GDPR) Information

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Necessary cookies

Register With us

The Children's Centres Registration Form

Data Protection and General Data Protection Regulation (GDPR) Information

Our use of cookies

Necessary cookies

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