ANDIESTRIPFORMFORAGSB

ANDIESTRIPFORMFORAGSB

FORM FOR SCHOOL TRIPS Form Preview
PARENTAL CONSENT FORM D
  • FORM D

  • PARENTAL CONSENT FORM

  • CURRENT MEDICAL INFORMATION ABOUT YOUR CHILD:

  • Does your son suffer from any Medical conditions or Allergies (please state severity and symptons and the treatment of each condition?)

  • I undertake to inform the Trip Leader as soon as possible of any changes in the medical circumstances of my son or if he has been in contact with any contagious or infectious diseases between the date this form is submitted and the start of the journey.

  • EMERGENCY CONTACT DETAILS FOR THIS TRIP:

  • CONTACT 1:

  •  -
  •  -
  • CONTACT 2:

  •  -
  •  -
  • FOR RESIDENTIAL VISITS AND EXCHANGES (This section MUST be completed)

  •  -
  • PLEASE NOTE: Failure to disclose sufficient information at this stage may result in your son beign withdrawn from a trip in the event of any discrepancy between his medical/dietary needs and the information provided to us.  If necessary the Trip Leader may contact you to discuss medical and dietary issues in greater detail and whether or not it is safe for your son to participate in the visit.

  • By selecting the SUBMIT button below i agree to the following for

     

    my son to:

    • take part in the above mentioned visit and confirm all the information contained on this form is up to date and correct .
    • to participate in any or all of the activities described.
    • acknowledge the need for a willingness to follow instructions and responsible behaviour on his part.
    • maybe have some free time when there will be remote supervision at the discretion of the Trip Leader.

    And i as his parent:

    • give permission for my son to receive medication from a medical professional as instructed and any emergency dental, medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities.
    • confirm i have read and agree to the AGSB General Terms and Conditions document enclosed with the Trip letter.
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