E X C U R S I O N
C O N S E N T
F O R M
Consent I give consent for my daughter …………………………………………..in Year………………… to attend the rehearsals at SHORE and Namaroo Conference Centre for the Faure Requiem on Tuesday 25th July and Tuesday 1st & 8th August ……………………………………………………………………………………………………………………………………………………………………………………………………
My daughter has the following special needs: …………………………………………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………………………………………………
I agree to: My daughter returning to school if necessary in the event of an illness, injury or non co-operation and to pay any expenses involved or to come and collect my child from the excursion; Re-imburse the school for any damage caused by my daughter Re-imburse the school for any hospital, medical or ambulance expenses incurred by the school on behalf of my daughter.
Medical Treatment In the event that reasonable attempts to contact the nominated “emergency contacts” have failed, I consent to the school, in the best interests of my child, and as it considers necessary or expedient, to: (please tick appropriate option) obtain medical advice and treatment; or obtain medical advice and treatment except for the following treatments: ……………………………………………………………………………………………………………………………………………………………………………………………………
If the school considers that the excluded treatment is necessary, I request that the school take the following steps in its place: ……………………………………………………………………………………………………………………………………………………………………………………………………
Parent’s Name: ……………………………………………………………………………………………Date: ………………………………………………… Parent’s Signature: …………………………………………………………………………………………………………………………………………….…… Student Declaration: I agree to observe the rules of the excursion and agree to co-operate with the teachers and presenters throughout the excursions.
Student’s Signature: ……………………………………………………………………………….. .Date: ……………………………………………