Ashmore OSHC Excursion Permission Form

Ashmore OSHC Excursion Permission Form

Ashmore OSHC excursion permission form.

Child’s details

Child’s name: ______DOB: ______

Swimming ability:Poor Good Excellent

Will be attending Excursion(s) – mark to indicate which excursion(s)

WEEK ONEWEEK TWO

Incursion one: The Science Factory 3/4/2018 Incursion one: Go Kart Wild 9/4/2018

Incursion two: Film Maker Series 5/4/2018 Incursion two: Bubble Soccer11/4/2018

Incursion three: Laser Tag13/4/2018

What to bring:

All children must bring a backpack, with a bucket hat, drink bottle, lunch box which includes their morning tea and lunch. All children must wear enclosed shoes and sun safe clothing ie: no singlet tops, to all sessions of Vacation Care. All incursion operators have current working with children check ( Blue Cards)

WEEK ONE:

Incursion one:

The Science Factory

Peter May ( Owner operator)

0414776633

Held in the hall and the children will attend with educators in groups set to ratio 1:12 for each session run. The first session will start at 10am and run for approximately 1.5hoursending at approximately 12pm.

Educator/Child ratio 1:12

Approximately 100 children with 10 educators will attend this incursion.

Incursion two:

Film Maker Series Workshop.

Ananiah Studios – 0424 538528

Superheroes, Villains and Fairy tales:

Kids really do have superpowers within they can use to save the world! No limitations, we help them create new worlds, travel through time and space, fly like Superman, fight crime as Batman, swing with Spiderman rope from skyscrapers in Metropolis, transform into Cinderella with an amazing ballgown or freeze some villains form “Frozen”. Kids are able to become any character and visit any place in the world just like in their imaginations as we transport them into a virtual world using Green Screen Technology to create their own photographic scenes or collaborative short film story. This incursion will run from 10am

Until 1pm and it will occur both in the hall and around the school grounds. The studio will have the final edited version to the

service before close of business.

Educator/child ratio 1:15

Approximately 100 children with 9 educators will attend this incursion.

WEEK TWO:

Incursion One:

Go Kart Wild

Dean & Janelle Nicholson0417432113 (Owner operator)

The children will be able to participate in go kart riding. This incursion will be held on the tennis courts and middle playground.

The children will participate in this incursion between the hours of 9am and 3pm.

The children will be given allocated time allowance per group to ensure fair distribution of the go karts for all children.

If your child has a safety helmet at home please bring in so they have one appropriately sized. Helmets will be provided also.

Educator/Child ratio is 1:12

Approximately 100 children and 10 educators will attend this incursion

Incursion Two:

Bubble Soccer

Sports Inflatables – 0448 619543

Bubble soccer is soccer in a giant inflatable bubble. Protected by their own Zorb ball, each teams aim is to score goals against the opponents while getting bumped into from any direction and rolling around on the grass. running from This incursionwill be run on the school oval from 10am until 4pm.

This game is safe and lots of fun for everyone and will be played two teams at a time, with the children broken into teams and rotated into the games in a round robin format.

Educator/Child ratio 1:14

Approximately 100 children and 9 educators will attend this incursion

Incursion Three:

Laser tag

Red Scorpion Laser Tag

Alex Kay – 0488 880485 ( Owner operator)

Red Scorpion Laser Skirmish will be providing an “army-themed” laser tag event.With their harmless Gaming Gunsthey will organize an inflatable battlefield on the oval for our games of laser skirmish. The trained blue carded staff will remain onsite to brief players and facilitate missions. The children will have 30 minute turns (approx 3 games) in teams 7 or 8. The teams will keep rotating throughout the day allowing the children at least two sessions beginning at 10am

and ending approximately 2pm.

Educator/Child ratio is 1:14

Approximately 100 children and 10 educators will attend this incursion.

Activity Risks

Ashmore P & C OSHC has conducted a Risk Assessment of each of the mentionedexcursions/incursionsthat children, educators and volunteers can take part of during the vacation care period and will be rostering supervising educators as per documented in the risk assessments.

Medical Information

  • I authorise any educators from Ashmore P & C OSHC to obtain or administer any medical assistance or treatment which they deem necessary for my child should any medical condition, illness or accident occur whilst in their care.
  • I understand that should any emergency occur the educators from Ashmore P & C OSHC will endeavour to contact the below emergency contacts as per policy 3.5 Excursion and Incursion policy, this states that the below person will be contacted in a timely manner once the services duty of care has been fulfilled.
  • I accept liability for all reasonable costs incurred by Ashmore OSHC in obtaining such medical assistance or treatment (including any transportation costs) and agree to repay the full amount of those costs.

I have provided Ashmore OSHC all relevant details of my child’s medical or physical needs on enrolment and where relevant have updated this information.

Medicare No:. ______Child’s position on card: ______

Private Health Insurance Company (if applicable): ______Membership No.:______

Emergency Contacts

Please Note: These contacts will be called when and if educators are unable to contact parent or guardians.

1st Contact: ______Best contact number/s: ______

2nd Contact: ______Best contact number/s: ______

Consent

By signing this form (below) I agree that:

  • I have read all of the information contained in this form in relation to the activity (including any attached material)
  • I give consent for my child, ______to participate in ______activity on ______
  • I will pay to Ashmore OSHC the costs detailed above for my child’s participation in the activity.

Parent/Carer Name: ______(Please Print)

Parent/Carer's Signature: ______Date:______/______/______

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