Parent Consent Form

PARENT CONSENT FORM

Central Australia

Monday 23rd June –Tuesday 1stJuly 2014

Adelaide, Coober Pedy, Uluru and Alice Springs (see attached itinerary for full details)

I give permission for my son/daughter ______to attend the campon the Central Australiafrom Monday 23rdJune to Tuesday 1stJuly 2014.

I have read all the information provided by the school in relation to the above camp, including any attached material. I understand that this camp includes travel on a bus to and from the camp, outdoor camping, bush walking and swimming.

I understand that my child is expected to adhere to the requirements of the Student Code of Conduct, and follow the specific rules and directions made or given before and during the camp by the supervising teachers and camp staff.

In the event of any serious act of misconduct on my child’s part, or other circumstances that give cause for concern for the welfare of my child or others, such as an illness or injury, I authorise the teacher in charge, to arrange for the return of my child to his/her home, after notifying me and the Principal of the circumstances. I agree to pay the additional expenses that this will incur.

I understand that no responsibility can be accepted by the Principal, staff or School Council of Buckley Park College or the DEECD, for the loss, damage or theft, of any personal property.

I authorise staff to provide appropriate medication, as specified on the medical information form, as required throughout the camp.

I understand that students’ mobile phones will be handed into staff each evening prior to bedtime, and returned the next morning.

Parent name: ______

Parent signature: ______Date: ______

STUDENT DECLARATION

I agree to be cooperative and helpful with teachers, leaders and camp staff members. I will participate in activities and support my peers. I agree to hand my mobile phone to the teachers in charge each evening.

If I do not follow these rules and instructions, I understand that consequences will be set at camp and that I may be sent home early.

Student name: ______

Student signature: ______Date: ______

Please list any dietary requirements (if any)______

______

______

[Form 3 - Parent Consent]Page 1