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Register Your Child

To register your child with Hopscotch, please complete the form below. You will be contacted shortly to confirm your booking. Please note that registration is only guaranteed upon receipt of full deposit.

Please note that * indicates a required field

About your child

* Child's First Name:

* Child's Surname:

* Gender:

* Date of birth (DOB) or Estimated date of birth (EDD)

* Address 1:

Address 2:

* City:

* County:

* Postcode:

Your details

* Parent / Guardian name:

* Relationship to the child:

Place of work:

* Home telephone:

Work telephone

* Mobile telephone:

* Email:

Add a secondary contact +

Secondary contact Remove secondary contact

* Parent / Guardian name:

* Relationship to the child:

Place of work:

* Home telephone:

Work telephone

* Mobile telephone:

* Email:

Nursery details

* Preferred Nursery:

* Preferred Start Date:

Which preferred sessions would you like your child to attend?

Please select applicable days and times

Select attendance days and times
	Monday	Tuesday	Wednesday	Thursday	Friday
07.30 - 08.00	Monday 07.30 - 08.00	Tuesday 07.30 - 08.00	Wednesday 07.30 - 08.00	Thursday 07.30 - 08.00	Friday 07.30 - 08.00
08.00 - 12.30	Monday 08.00 - 12.30	Tuesday 08.00 - 12.30	Wednesday 08.00 - 12.30	Thursday 08.00 - 12.30	Friday 08.00 - 12.30
12.30 - 13.30	Monday 12.30 - 13.30	Tuesday 12.30 - 13.30	Wednesday 12.30 - 13.30	Thursday 12.30 - 13.30	Friday 12.30 - 13.30
13.30 - 17.30	Monday 13.30 - 17.30	Tuesday 13.30 - 17.30	Wednesday 13.30 - 17.30	Thursday 13.30 - 17.30	Friday 13.30 - 17.30
17.30 - 18.00	Monday 17.30 - 18.00	Tuesday 17.30 - 18.00	Wednesday 17.30 - 18.00	Thursday 17.30 - 18.00	Friday 17.30 - 18.00
18.00 - 18.30**	Monday 18.00 - 18.30	Tuesday 18.00 - 18.30	Wednesday 18.00 - 18.30	Thursday 18.00 - 18.30	Friday 18.00 - 18.30
Hot Lunch	Monday - hot lunch	Tuesday - hot lunch	Wednesday - hot lunch	Thursday - hot lunch	Friday - hot lunch
Hot Tea	Monday tea	Tuesday tea	Wednesday tea	Thursday tea	Friday tea

** Please note that these times are currently only available for Hove Station.

Additional information

* Does your child have any dietary requirements?

* Please state:

* Does your child have any allergies

* Please list their allergies:

* Does your child have any medical conditions?

* Please list their conditions:

Other information:

Please provide any further information we should know including any reasonable adjustments we could make to support your child at Hopscotch?

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