Rossall School Exeat Form

An exeat is any time a boarder spends away from the school campus during the official term dates. This can include requests for day visits or overnight visits. Please be aware that for an exeat to be granted students must be supervised by a responsible adult, over the age of 25 , who will act in loco parentis for the duration of the requested exeat and is responsible for the student from the time they leave the school campus until the time they return to the school campus.

Name of adult requesting the exeat*

First NameLast Name

Your email address*

example@example.com

Your relationship to the exeating student*

Name of exeating student*

First NameLast Name

Student's Year Group*

Student's Boarding House*

Date of Departure from School*

Date

Time of Departure from School*

:HourMinutes

Arrangements for travel away from School*

(Collection by host family/public transport, etc)

Overnight accommodation address*

Address Line 1

Address Line 2

Town/CityCounty/State

Post CodeCountry (if not UK)

Arrangements for return travel to School*

(Dropped off by host family/public transport, etc)

Date of Arrival back to School*

Date

Time of Arrival back at School*

:HourMinutes

Please provide details below of the supervising adult who will act in loco parentis of the student for the duration of the exeat

Name of the supervising adult*

First NameLast Name

Email address of the supervising adult*

example@example.com

Phone Number of the supervising adult*

What is the purpose of the exeat?*

Confirmation of communication*

I can confirm that as the parent of the exeating student I have communicated directly with the adult who will act in loco parentis of my child for the duration of the exeat.I can confirm that, as the supervising adult for the duration of the requested exeat, I have directly communicated with the parents of the exeating student.

Will the exeat include attendance at a party celebration*

YesNo

Rossall Exeat Request Form