Medical and Allergy Requirements
Childs Name:
First Name
Last Name
Allergy/ Medical Condition
Please include what staff should do in an emergency and medication required
Please read and sign
Play Pals cannot administer medication unless it has been prescribed by a doctor.
Children may use inhalers independently providing parental/carer written permission has been given.
By signing this parents/carer are taking responsibility for their child’s health needs.
It is the responsibility of the parent/carer to provide and maintain medication.
Parent/ Carer signature:
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Should be Empty: