Pupil Free Day Consent Form

Craigburn OSHC

Pupil Free Day Consent Form
Friday 26th November 2021
7:00am to 6:15pm

15 Murrays Hill Road Flagstaff Hill SA 5159
8270 1620 or 0427 271 768
cps.oshc820@schools.sa.edu.au

Please be mindful that this is subject to change at short notice due to COVID-19 restrictions under the advice of Department for Education.
Families will be notified by Xplor admin post, text and email if circumstances change.
Child 1 Full Name

First NameLast Name
Travel Sickness- Child 1
Child 2 Full Name

First NameLast Name
Travel Sickness- Child 2
Child 3 Full Name

First NameLast Name
Travel Sickness- Child 3
Child 4 Full Name

First NameLast Name
Travel Sickness- Child 4
A 2021 Craigburn OSHC Enrolment Form has been completed
Pupil Free Day Excursion

Please complete and submit consent form online and then request Friday 26th November via the Xplor app. Once we have received your consent form we will process your requested session.
Friday 26th November 2021- Excursion Adelaide Zoo

I give permission for my child/ren to participatein the Excursion to: Where: Adealide Zoo & Nature Playground Date: Friday 26th November 2021 Location: Frome Road Adealide SA 5000 Proposed Activities: Explore the zoo, recess, lunch & play at playground Transport: Willunga Charter bus with seatbelts Times(aproximate): 9:15am – 3:20pm Anticipated number of children: 40 Ratio: 1:8 Anticipated number of staff: 5
Parent Declaration

By signing this Consent Form, I agree to and understand the following: (Please tick)
Illness, Accident & Emergency Authority
Cancellations
Transportation
Fee
Fees
Late Collection Fees
Behaviour
Excursion Activities
Excursion Departure
Photograph Consent
Community Walking Consent
Parent/Guardian Signature
Parent/Guardian Full Name

First NameLast Name
Phone Number
I certify that the information entered on this form is true to the best of my knowledge and I undertake to inform the service if any of these details change.

I have read and understood the excursion information provided above, by signing this form I give permission for my child/ren to attend the excursionI have selected.
Signature
Date
Should be Empty:

Craigburn OSHC

Pupil Free Day Excursion

Parent Declaration

Parent/Guardian Signature