Excursion Permission Form Kariong Out of Hours School Care - Excursion Authorisation/Permissions Form Please complete the following to provide your permission. Excursion Destination(s) * Parent / Guardian Full Name * Email * Preferred Contact Number * Child/Children Details Child/Children Full Name(s) * Do any children have any medical conditions OR medication requirements? * Yes No I confirm that my child/children, listed below has the following medical condition: * To confirm the following medication will be provided by me prior to the Excursion(s): * Parent / Guardian Authorisation I hereby give permission for my child/children listed above to participate in the excursion(s) listed above. I confirm that I have read and understood the details of the excursion(s), including the Excursion Risk Assessment and Management Plan, and that I understand the travel arrangements. In the event of an injury or emergency, I acknowledge that the supervising educator will attempt to contact me. In an emergency, I authorise the Service to obtain all necessary medical assistance, including ambulance transport, medication and hospital admission. Parent / Guardian Signature * signature keyboard Clear Date * Submit If you are human, leave this field blank.
