LOOSH Special Arrangements Permission

Special Arrangements are where a activity/lesson is arranged by a Parent/Guardian, and a child attends this activity in LOOSH time. All children attending lessons need to be signed out by an authorised person before going to their special arrangement, and must be signed back into LOOSH care (unless the child is not returning after their lesson, in which case the authorised person must sign out the child on the iPad). LOOSH is not responsible for children while they are signed out to attend the activity specified in this form.

When arranging an activity for your child, please ensure that the tutor/teacher is aware:

They must sign your child out of LOOSH when they take them and inform the gate greeter that they are taking your child;

They must sign your child back into LOOSH upon return and that the LOOSH gate greeter must sight your child;

Children must be sighted by LOOSH educators and signed into LOOSH care before they can be signed out for an activity (approx. 3:20pm in ASC);

They must inform the LOOSH gate greeter if they are taking your child early or late to a lesson and the time they expect to return.

Child's Name *

First Name Last Name

Year *

Lesson / activity the child will be attending *

Activity Location *

Onsite Offsite

Name of tutor *

Contact number of tutor *

Please enter a valid phone number.

Starting date of lesson/activity *

Date

Frequency of the lesson *

One off event Weekly Fortnightly Other

Program the lesson/activity will be happening in *

Day of the week the lesson/activity will occur

Monday Tuesday Wednesday Thursday Friday

Time the tutor will sign my child out of LOOSH *

Hour Minutes

AM/PM Option

Length / duration of lesson *

My child *

will return to LOOSH after their lesson/activity will NOT return to LOOSH after their lesson/ activity

Parent/Guardian permission

By signing this form:

I accept that LOOSH educators are not responsible for ensuring my child attends their lesson/activity. It is up to the individual tutors to sign my child out of and back into the care of LOOSH.

I accept that my child attending and travelling to and from activities during an OOSH session will not be under the care or supervision of the LOOSH staff.

I understand that LOOSH staff are not responsible for my child whilst they are signed out from the OOSH centre for the purpose of a lesson/activity

I understand that sometimes due to unforseen circumstances that lessons/ activities may run early or late and LOOSH staff will allow my child to attend their lesson early/late within 30 mins of their usual scheduled lesson time.

I understand that if I collect my child directly from the extra curricular activity when they would usually return to LOOSH, I must notify the centre that they will not be returning and sign my child out of LOOSH.

I understand that if the tutor is going to sign out my child with the intention of not returning to LOOSH I must add the tutor as an authorised pick up person in my Qikkids account.

I understand that it is my responsibility to notify LOOSH of any changes to the above arrangement including date/ time and person signing my child in/out of LOOSH for their lesson. If I fail to notify LOOSH of any changes to the arrangement I understand I will be charged a $10 non-notification fee.

Name of Parent/Guardian *

First Name Last Name

Signature *

Clear

Date

Leichhardt OOSH

Email: admin@loosh.org.au

Phone: 0404137500