Early Years Funded Entitlement Parent Declaration Form 

This form is to be completed by the parent of an eligible child together with the provider of early years education. Bracketed numbers indicate that there are help notes for your reference on the separate sheet Notes on completing the Parent Declaration Form. Please ensure you complete all four pages of this form.

Child’s full legal name (as shown in the child’s ID reference):

Parent/carer’s full legal name

This page must be completed if your child is splitting the EYFE across more than one provider. EYFE can be split between multiple providers, but your child can attend a maximum of two sites in one day (Notes 7 and 10).

I understand that:

• If I am accessing EYFE hours, it must not be compulsory for me to pay for food and consumables such as nappies or sun cream and for services such as trips and yoga. These charges must not be a condition of access. I must be given options for reasonable alternatives which could include allowing me to supply my own or waiving the cost of these items.
• Voluntary contributions are acceptable for items other than those listed above, but must not be included in any invoice totals or added as a condition of access.
• I will be charged for any additional, private paid hours at my chosen setting according to their usual terms and conditions. However, taking up any additional private paid hours must not be a condition of access.
• Invoices and receipts issued by my chosen setting will be clear, transparent, and itemised allowing me to see that I have received my child’s EYFE completely free of charge and I am able to understand any fees, paid for additional hours, or services.
• If my child is eligible for Universal EYFE or LA Issued EYFE, I can claim up to a maximum of 15 funded hours for my child per week, across 38 weeks in the year (570 hours per year). For children eligible for EYFE for Working Families I can claim a maximum of 30 hours per week over 38 weeks (1140 hours per year). (Notes 9 and 11).
• If I sign up with a provider, it is my intention to send my child for the funded hours as per the pattern of attendance completed on this form. It is fraudulent to sign up to more EYFE hours than my child is accessing (note 12).
• I can request, via the provider, changes to the number of hours claimed, if this is done before the headcount date of each term. (Notes 13 and 15).
• I must show the provider confirmation of my child’s date of birth (note 1).
• If eligible for Disability Access Fund, I must give the provider a copy (no originals) of paperwork to show my child is eligible and in receipt of Disability Living Allowance and have nominated only one provider of my choice to receive the one-off Disability Access Fund payment and will discuss how funds will be spent with my provider (note 4).
• I must provide my name, date of birth and National Insurance or National Asylum Support Service number which will be used by the provider to check eligibility for Early Years Pupil Premium (EYPP), which is paid to the provider. I am aware of how to claim under the non-economic eligibility criteria. If eligible, EYPP and an additional supplement will only apply to the first 15 hours EYFE claimed (note 5).
• If eligible for Working Families EYFE, I give the provider permission to verify my 11-digit eligibility code and provide my child’s date of birth and my National Insurance number which will be used by the provider and the Local Authority to verify my eligibility code (note 3).
• I understand that if my child attends a provider on a school site, this does not influence the child’s chance of obtaining a place in the reception or foundation class at the school.

This form will not be accepted as evidence to support claiming DAF or settle funding disputes without both the parent and provider signing and dating this declaration.

This section should only be used to record any changes to the child/parent or address information provided on the original Parent Declaration overleaf. Each change must be signed and/or dated by the parent and the provider where indicated.

I wish to notify you of a change to my child’s name, my name and/or our address (please complete details as appropriate below):

Child’s new legal name (as shown in the child’s ID reference)

Parent/carer’s new legal name

Note to Provider: Please ensure any changes are updated via the Online Provider Portal when you next submit your child-level headcount claim for this child.