Contact Us

Parents Registration

Your Details

Please complete the below registration form, either by completing the mandatory fields (marked with an askerisk) only, with the view to providing us with full details at a later date for precise requirements, or provide us now with the full details of your childcare requirements. We will then contact you, to discuss further details, and answer any questions you may have.

Title:

First Name:

Last Name:

Address 1:

Address 2:

Town / Village:

County:

Postcode:

Mobile:

Email:

Confirm Email:

Second Parent's Name:

Preferred Method of Contact:

Phone

Email

Text

Childrens Details

Child 1

Gender:

Boy

Girl

Month and Year of Birth:

School and Nurseries attended:

Child 2

Gender:

Boy

Girl

Month and Year of Birth:

School and Nurseries attended:

Child 3

Gender:

Boy

Girl

Month and Year of Birth:

School and Nurseries attended:

Child 4

Gender:

Boy

Girl

Month and Year of Birth:

School and Nurseries attended:

Child 5

Gender:

Boy

Girl

Month and Year of Birth:

School and Nurseries attended:

New Baby

Is a new baby expected?

Yes

No

Expected Births:

Singleton

Twins

Triplets

E.D.D:

Additional Notes:

Requirements

You can submit your registration form now having completed just the above sections, however it would be beneficial if you could complete the rest of this form.

Family Details

Household Details

Are any other staff employed to work at the home?

Yes

No

If yes, please provide details.

Are you a smoking household?

Yes

No

Do any have any household pets?

Yes

No

If yes, please provide details.

Will the carer be expected to help with the pets?

Yes

No

Childcare Requirements

Childcarer Profile

Additional perks you would like to mention:

Please select if you choose to conduct your search for a suitable candidate through Elizabeth Henry Nannies, on a sole agency basis, and receive a 20% discount on the permanent placement fee:

Yes

No

I confirm that the information that I have supplied is accurate to the best of my knowledge and I have read, understood and agree to abide by Elizabeth Henry Nannies Terms of Business and Fee Structure below:

I Agree

Elizabeth Henry Nannies Terms of Business and Fee Structure