PERMISSION FOR STUDENT TO ATTEND BASKETBALL DAY School Name: Class/Year: Middle and Senior School MacKillop Catholic College Times and Dates of activity: Student requirements: Monday 9th April 2018 Appropriate footwear, full sport uniform, hat, water bottle Darwin Basketball Stadium, 220 Abala Road Marrara, and personal sunscreen if allergic to common ones. NT, 0812 9:00am 2:00pm – Students to go to homeform to have their names marked off the roll, then meet at the breeze way to catch a bus to Darwin Basketball Stadium. Students will participate in a round robin competition for the duration of the day. They will be returning via bus at 2pm to ensure early bus students are back in time to go home. Planned Transport: School Bus X Hire Bus Town Bus Staff/Parent Vehicle Student’s Own Vehicle Walking X Other Costs associated with activity: PARRS levy $5 Transport costs $15 = $20 $20 to be paid through SCHOOL FEES (please do not send cash to school) Please complete all details below and return it to Miss Dendle or the front office by Monday 2/04/2018, failure to do so could result in your child being unable to participate in the activity. Teacher Signature Principal Signature Student’s Given Names: Student Homeform: Student’s Family Name: Student’s Date of Birth: Gender: Male Aboriginal or Torres Strait Islander Female Origin?: Yes No Parent/Caregiver’s Name: Parent/Caregiver Telephone Number: Work: Home: Mobile: Emergency Contact Name (alternate contact): Emergency Contact Telephone Number: Work: Home: Mobile: Known allergies (drug reaction etc.): Dietary restrictions: Student’s medical details: Date of last tetanus injection: Is the student under medication? (If yes, name medication and attach instructions) Has your child any special medical condition, physical or psychological limitations or cultural restrictions which may affect her/him whilst taking part in any activities? Please provide full details (attach information if necessary). Please provide any other information which you believe may help staff provide the best possible care. ………………………………………………………………………………………………………………………… Does your child have permission to have their photograph taken and used in PARRS and MacKillop promotional information and flyers? Yes No
PERMISSION FOR STUDENT TO ATTEND BASKETBALL DAY School Name: MacKillop Catholic College Class/Year: Middle and Senior School Times and Dates of activity: Monday 9th April 2018 Darwin Basketball Stadium, 220 Abala Road Marrara, NT, 0812 9:00am – 2:00pm Student requirements: Appropriate footwear, full sport uniform, hat, water bottle and personal sunscreen if allergic to common ones. Students to go to homeform to have their names marked off the roll, then meet at the breeze way to catch a bus to Darwin Basketball Stadium. Students will participate in a round robin competition for the duration of the day. They will be returning via bus at 2pm to ensure early bus students are back in time to go home. Planned Transport: School Bus X Hire Bus Town Bus Staff/Parent Vehicle Student’s Own Vehicle Walking X Other Costs associated with activity: PARRS levy $5 Transport costs $15 = $20 $20 to be paid through SCHOOL FEES (please do not send cash to school) Please complete all details below and return it to Miss Dendle or the front office by Monday 2/04/2018, failure to do so could result in your child being unable to participate in the activity. Teacher Signature Principal Signature Student’s Family Name: Student’s Given Names: Student Homeform: Student’s Date of Birth: Gender: Male Female Aboriginal or Torres Strait Islander Origin?: Yes No Parent/Caregiver’s Name: Parent/Caregiver Telephone Number: Work: Home: Mobile: Emergency Contact Name (alternate contact): Emergency Contact Telephone Number: Work: Home: Mobile: Student’s medical details: Date of last tetanus injection: Known allergies (drug reaction etc.): Dietary restrictions: Is the student under medication? (If yes, name medication and attach instructions) Has your child any special medical condition, physical or psychological limitations or cultural restrictions which may affect her/him whilst taking part in any activities? Please provide full details (attach information if necessary). Please provide any other information which you believe may help staff provide the best possible care. ………………………………………………………………………………………………………………………… Does your child have permission to have their photograph taken and used in PARRS and MacKillop promotional information and flyers? Yes No
Basketball-Permission-Form-2018.docx