Wced Indemnity Form 40384s

PARENTAL CONSENT FORM SCHOOL OUTINGS AND SPORT TOURS I, …………………………………………………………………………………………..(name and surname of parent/guardian), the undersigned, being the parent/guardian of …………………………………………………… (name and surname of learner) give him/her permission to attend the …………………………………………….…………….. (name of event) which is being held at/in ……………………………………………………………………… (name of place) from/on ………………………………………………………..(dates). I also give permission for him/her to be transported by bus from and to his/her school. I also give consent for him/her to be accommodated in a hotel for the duration of the outing/tournament (with the assurance that there will be strict teacher supervision). I hereby authorise the teacher in charge to make arrangements for the welfare of my son/daughter (including medical or surgical treatment) in case of an emergency. I give my consent for my son/daughter to be transported by private car/vehicle, driven by a teacher, parent or another person as the case may be, in case of an emergency. PARTICULARS OF PARENTS OR GUARDIANS (Also to be used in case of emergency) Full name: ………………………………………………………………………… Home address: ……………………………………………………………………. ……………………………………………………………………. ……………………………………………………………………. Home telephone no.: …………………………….. Work telephone no.: ……………………………. Cellphone no.: ……………………………………. MEDICAL PARTICULARS Name of doctor: ………………………………………………………… Tel.: ……………………………… Name of medical aid scheme: ………………………………………………………………………... Name of principal member:

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hip no. ………………………………………… Signature of parent/guardian …………………………………… Date: ………………