|
Form
of Consent
Pupils name:
. Year:
.. Tutor:
.
BY THIS FORM I GIVE MY
CONSENT to my child taking part in the following activity:
Dates
Visit/Activity:
UPON THE FOLLOWING TERMS:
1)
I understand and acknowledge that the School has
employers and public liability insurance cover and in
addition, the Pupil Accident
Insurance, paid by parents on a termly basis covers personal accident to pupils
or loss or damage to personal effects and clothing when the School is not at
fault. (Details of insurance cover may be obtained from the Registrar).
2)
I will ensure that my child is properly equipped for
the activity as laid down by the Teacher in Charge.
3)
If I have been advised that my child should take
packed meals and pocket money, I will ensure that these
are provided.
4)
I understand that the cost of the visit includes a
refund for School meals not taken (if applicable).
5)
I give permission for my child to take part in all
activities relating to the trip.
6)
I give permission for my child to travel in seat
belted transport.
7)
I agree that, if my son/daughter persists (after
clear warning) with behaviour likely to threaten the safety, well-being or
happiness of the party. I will arrange
his/her immediate return home at my expense and with the minimum of
inconvenience to the adults leading the party.
The decision will be made by the Teacher in Charge of the visit, who
will contact me, if possible, one stage before making this decision.
SPECIAL
INSTRUCTIONS (eg medical requirements drugs, treatment, etc.)
...
...
Doctors
name, address and telephone number:
.
...
I AUTHORISE the
Teacher in Charge to sign the necessary papers on my behalf should my child
require emergency medical treatment or an operation whilst on the visit. I understand that this will only be necessary
if the School is unable to contact us/me.
Signature of
Parent/Guardian:
..
Contact telephone no.s:
..
Name of Teacher in
Charge:
|
