Form 18 - EOTC Health Profile

Form 18 - EOTC Health Profile

This profile is designed to assist in the care of all participants at EOTC events, including adults. One form must be completed for EACH participant.
- When you submit the form you will receive a confirmation email. Please keep this email and use the edit link to update the information you have provided if the details change.
- This form will remain in place (along with any updated details) for the 2021 school year.
Privacy Statement
Please note: The personal information being collected on this form is for the purpose of running EOTC events. It won't be used for any other purpose except in accordance with the Privacy Act 1993. You have the right under that Act to access and seek correction of the information from the school.

Agreement/Save/Submit
To be read and signed by parent/caregiver of child participant (please tick all items):*

I agree that if prescribed medication needs to be administered, a designated adult will be assigned to do this. I will ensure that prescribed medication is clearly labelled, securely fastened and handed to the designated adult with instructions on its administration.I will inform the school as soon as possible of any changes in the medical or other circumstances between now and the commencement of the event.I agree to my child/myself receiving any emergency medical, dental, or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities present.Any medical costs not covered by ACC or a community service card will be paid by me.If my child is involved in a serious disciplinary problem, including the use of illegal substances and/or alcohol, or actions that threaten the safety of others, s/he will be sent home at my expense.
Signature*

Clear
Should be Empty: