Name of Child * Child's Date of Birth * Child's Gender * --Please select-- Female Male Required Attendance * --Please select-- Full-Time Part-Time Days Required (If Part-Time) [Please indicate preferred days and whether you could be flexible] Preferred Start Date * Preferred Nursery Location --Please select-- Battersea Central Methodist Mission, 20-22 York Road, SW11 3QA Brixton Hill - 228 Brixton Hill, London, SW2 1HE Mother's details Mother's Full Name * Home Address * Postcode * Mother's Home Phone * Mother's Mobile Phone * Mother's Email * Mother's Occupation * Father's details Father's Full Name * Home Address (If different from Mother's) Postcode (If different from Mother's) Father's Home Phone (If different from Mother's) Father's Mobile Phone * Father's Email * Father's Occupation * Other details Religion Child's Doctor * Doctor's Address * Doctor's Postcode * Doctor's Telephone * Where did you hear about Destiny Kids Nursery? I agree to pay £50.00 Registration fee. Please make cheque payable to Destiny Kids Nursery Limited. Submit