Excursion/Incursion Authorisation Form Kariong Out of Hours School Care - Excursion/Incursion Authorisation/Permissions Form Please complete the following to provide your permission. Excursion Destination/Incursion Activity * Parent / Guardian Full Name * Email * Preferred Contact Number * Child Details Please use the 'add' button below if you have more than 1 child. Child Full Name * Any medical conditions OR medication requirements? * Yes No I confirm that my child has the following medical condition: * To confirm the following medication is required: * plus1 Add another Child minus1 Remove Parent / Guardian Authorisation I hereby give permission for my child/children listed above to participate in the excursion list above. I confirm that I have read the details of this excursion and understand the travel arrangements. In the event of an injury or emergency, I acknowledge that the supervising educator will attempt to contact me. 4. 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.
