M2,9:20 'RIM4RY "C988; P231"++"4& !4 A!!2&- .

A1P

Year 6 Raincliff Camp 2014 25, 26 & 27th March

Please fill out this information and return promptly to your childs classroom teacher.

!his form includes, Permission to attend camp 1edical "nformation .ontact Phone &umbers

0ame of Chil!(
I give permission for Canter$#r%& to atten! the Year 6 camp at Raincliff, "o#th

'lease note( If a chil! nee!s to $e ret#rne! home as a conse)#ence of their $ehavio#r, the parents or caregiver of that chil! *ill meet the cost of the transport re)#ire!& I agree to pa% for an% !amage ca#se! on camp $% m% chil!& +,he total amo#nt $eing fair an! reasona$le-& e&g& a $ro.en *in!o*&
"igne!( /ate(

Me!ical Information
1. Any medical/personal condition eg allergies, asthma, bed wetting etc.

2.

Any medication your child requires and instructions for administration.

3.

as your child had a !etanus "n#ection$

%es

&o

%ear gi'en (((((

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" authorise the obtaining of medical assistance, if in the opinion of camp staff such action is necessary. " authorise the administering of paracetamol to my child if needed. -ate, ((((((((((((

+igned, (((((((((((((((((((

Contact 'hone 0#m$ers 1 /a% an! 2vening

.ontact person /-ay0 ((((((((((((((((((((( -ay !elephone ((((((((((((((

.ontact person /&ight0

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&ight !elephone ((((((((((((((

'lease 0ote( ,his information *ill $e confi!ential& "#ita$l% stoc.e! 3irst 4i! 5its *ill $e ta.en to the camp&

,he estimate! cost for the three !a%s is 6100 per chil! $#t this *ill $e revie*e! an! a!7#ste! *hen )#otes for foo! an! transport are receive!& 'lease !o 08, pa% this %et as it is onl% an estimate& "t#art Coo.e, 5er%n 9oo.er an! Chris M#rph%