Parental Consent Form for Sports Fixtures

This parental consent form covers the whole 2018/2019 academic year. The password is included in the letter sent to you.

Child's Full Name:* Date of Birth:* Child's Year Group* Child's Tutor Group (if known) Next of Kin:*

Next of Kin Contact Numbers:

Mobile* Work Home* Email address:* Home Address:*

Alternative Emergency Contact Details:

Name:* Telephone Number* Address:*

2. Medical Information about your child:

GPs / Consultants name:* Telephone number:* Address:* a. Does your child have any pre-existing/ or current medical condition or disabilities?* If YES, please give brief details: b. Is your child currently taking any medication?* if YES, please give brief details: c. Is your child currently receiving medical treatment?* If YES, please give brief details:

I agree to my child receiving medication as I have instructed. I authorise the leaders and the first aiders on this visit to give permission for my child to receive any emergency:

Dental Treatment* Medical Treatment*

Surgical treatment (including the administration of anaesthetic as considered necessary by the medical authorities present, if this should occur at a time when my consent to a particular treatment cannot otherwise reasonably be obtained).

Blood Transfusions* Resuscitation*

I understand the extent and limitations of the insurance cover provided. Signed:* Relationship to the child Date* Full name (capitals):* Password*

Idsall School

Parental Consent Form for Sports Fixtures

Cookie Policy