Extra Curricular Permission Form

Extra Curricular Permission Form

Morningside State School Outside School Hours Care (MSS OSHC)
Child's Name*

First NameLast Name
Child Date of Birth*

DayMonthYear
Date
Extra Curricular Activity Type*
e.g. Tennis
Extra Curricular Provider Name *
e.g. Hamptons Swim School
Extra Curricular Main Contact Details*
e.g. Email address or phone number
Day/s of week for activty*

MondayTuesdayWednesdayThursdayFriday
Extra Curricular Location (inside school grounds only for OSHC to deliver child)*
e.g. School Hall
Start Date of Activity (FIRST DAY CHILD WILL GO)*

DayMonthYear
Date
End Date of Activity (LAST DAY CHILD WILL GO)*

DayMonthYear
Date
Start Time of Activity*

Hour Minutes

AM/PM Option
End Time of Activity*

Hour Minutes

AM/PM Option
Arrival to activity

An OSHC educator or the extra curricular staff will escort my child directly to the activity provider and my child will be signed out of the service.
Departure from activity*

Yes (OSHC will collect child and sign them back into the service)No (parent will collect child and child will remain signed out of the service )
Parent/Legal Guardian Name*

First NameLast Name
Parent Phone Number*
I, the parent or legal guardian of the child, give my permission for the child to participate in the extra-curricular actvity as stated in this form. I acknowledge that:
- I acknowledge that I must inform MSS OSHC when this arrangement changes.
- I acknowledge that MSS OSHC will sign my child out of the service at the start time of the extra-activityas per above.
- I understand that whilst my child is at the extra-curricular activity they are signed out of MSS OSHC and the activity provider is responsible for my child.
- I understand that I will still be charged for the MSS OSHC session if my child is booked in or attends OSHC.
- I acknowledge that MSS OSHC will sign my child into the service when they arrive back from the extra-activity at the arrival time as per above.
- Once my child has returned to MSS OSHC and has been signed in, MSS OSHC is responsible for their care.
- I understand that MSS OSHC will choose the most appropriate travel path when walking my child to the activity.
Parent's Signature*

Clear
Date Signed*

DayMonthYear
Date
Should be Empty: