Extra Curricular 2024 Permission Form

1

Childs Name* This field is required.

First Name

Last Name

2

Activity Attending* This field is required.

3

Name of Parent/Guardian completing this form

4

Location of Activity* This field is required.

Hall

Backfield

Library

Other

5

Date commencing:* This field is required.

Date

6

Details of educational facility/provider- name, address and phone (if known)

7

Method of travel

Walking (Activity is onsite) Metella Road Public School 117-131 Metella Road Toongabbie 2146

Chartered bus, car or coach (with seatbelts) Please email the service further details of the scheduled travel arrangements.

8

Weekly during term* This field is required.

Term 1

Term 2

Term 3

Term 4

11

I accept that Metella Road OOSH educators will remind my child/ren to attend the extra curricular activity but will not be held responsible if my child does not go when reminded.* This field is required.

I Agree

12

My child will be absent from:* This field is required.

Hour

Minutes

13

My child will be returning at:

Hour

Minutes

14

Will your child be returning to the centre after their extracurricular activity?* This field is required.Please note: If you select No, your child will be signed out at the commencement of their activity and a staff member WILL NOT pick them up at the end of their activity. If you select YES, your child will be collected/ must return at the conclusion of their activity.

YES

NO

15

I accept that my child/ren attendning and travelling to and from activities during an OOSH session will not be under the supervision of the OOSH staff* This field is required.

I Agree

16

I understand that OOSH staff are not responsible for my child whilst they are absent from the centre* This field is required.

I Agree

17

I understand that OOSH staff are not responsible and will not handle any payments on behalf of the family to extra curricular providers* This field is required.

I Agree

18

Signature

Clear