Parent/Caregiver Information and Consent Forms

Parents should be informed about the following before permission is obtained for their child to participate in a sport program or specific sport fixture:

• location
• costs, eg. facility entry, travel, equipment hire
• mode of travel-bus, walking, private vehicle, train (students are not permitted to change the specified mode of transport without written permission from the parents/caregivers)
• nature of the activity and the supervision/instruction provided
• period or 'season' over which the program will be conducted and the activities to be undertaken
• dismissal times
• Special requirements, eg. provision of sun protection items, personal water supply, mandatory or recommended use of personal protective equipment, any special clothing to be worn, swimming qualifications required of participants (eg. for sailing).

This procedure should apply whether the activity is undertaken as part of the intra and inter-school sport program, school carnivals, outdoor recreation activities, PSSA and CHSSA knockout fixtures or zone, area and state trials or fixtures. Commonly, where students are involved regularly in one sport in the weekly sport program, permission is sought for one school term or a ‘block’ of sport.

For excursions involving swimming or water activities, parents must indicate the swimming ability of their child. The following is an extract from the Memorandum to Principals Excursions and Other Visits 97/137:

Where any excursion involves swimming or water activities, principals may encourage but not insist that parents provide any floatation devices considered necessary for students. Parents must be asked to indicate the swimming ability of their children when giving consent for students to participate in excursions. If parents indicate students are poor or non swimmers and no floatation devices are available for use by students, principals will need to assess whether such students should participate in the swimming or water activities of the excursion. This assessment must take place irrespective of parental permission for the
students to participate in the swimming or water activities.

The memorandum also includes a Parent or Caregiver Information and Consent Form which incorporates a specific permission section where an excursion will involve swimming.

Information concerning the wearing of personal protective equipment, whether recommended (eg. genital protectors for baseball) or mandatory (eg. eyewear for squash) should be conveyed to students and parents/caregivers either in the consent form or attached as additional information. Alternatively, teachers who are in charge of each activity could disseminate the information directly to parents via team members.

Note:

The following Parent/Caregiver Consent and Information Forms are provided for the use of schools. In noting the nature and variety of sport and physical activities, the forms should be amended as required.

Attachment 1: Examples of Information Incorporated in Permission Forms

Dear Parent/Caregiver

Your son/daughter _____________________ of Roll Class ______________________

has gained selection in the Wallaby Primary School athletics team. He/she has deserved this school representation with
excellent performances at the recent school carnival. Details of the Zone carnival are:

______________________ will be competing in the following events and indicated with a cross:

If your child cannot compete through illness or another reason, it would be appreciated if the team manager could be informed immediately.

Dear Parent/Caregiver

The school’s cross country carnival is scheduled for Wednesday April 20,1999 at Wallaby Oval. The events will be conducted over the following distances and at the times indicated:

This carnival has been planned as a culminating event where students have had prior planned opportunities to prepare physically for the event.

Students will be instructed to proceed at their own pace to avoid over exertion and physical stress. Students will walk from the school to the oval at 12.30pm accompanied by class teachers. All competitors will walk the course at 12.45pm. Students will return to school in time for normal dismissal.

Participation details:

• sports shoes are to be worn in the event. Spikes are not permitted
• parents are advised to provide adequate sun protection for their child eg. 15+ broad spectrum, water resistant sunscreen and a hat. Lightweight clothing is recommended
• the course will not involve running on public roads
• in warm weather, dehydration can be a problem. Drink stations will be set up at appropriate points. Students will be encouraged to drink prior to, during and at the conclusion of the event
• asthma medication should be carried by competitors as required
• if prevailing conditions on the day are considered a risk to students, the event will be postponed, however students
  are advised to be prepared for any type of weather.

If your child has a medical condition that will preclude or limit involvement, please indicate this in the following section which is to be returned to school.

Attachment 2: Sports Activity - Parent/Caregiver Information and Consent Form

Your son/daughter ___________________________________ has been selected to represent

Travel will be by ___________________. The total cost of the activity is $ ___________

The students will depart from

and return to

Accommodation (if overnight) :    __________________________________

The group will be supervised by: ___________________________________

Additional information/special requirements for participation:
___________________________ ________________________________

___________________________ ________________________________

Principal _______________________________________

Teacher in charge of the activity ______________________

PLEASE COMPLETE THE SECTION BELOW AND RETURN BY: _______________(Date)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I hereby give my consent to my son/daughter

to represent 

Special needs of my child which you should be aware (eg. allergies, medication, etc) ___________

__________________________________________________________________________

To the best of my knowledge, he/she has no medical condition, disability or injury which puts him/her at risk in participating in the sport activity.

In the event of illness or injury, I authorise the seeking of such medical assistance on my behalf that my child may require.

Medicare No. __________________________ (for use at medical centres, surgeries).

Contact Number: Work: _____________________

Home: __________________________________ Other: ___________________________

Signature of Parent/Caregiver: ______________________________ Date ___________

Attachment 3: A Message to Parents/Caregivers

Special Swimming Scheme

Arrangements have been made to include swimming instruction in the curriculum for boys and girls in our school.

The Department of Education and Training Special Swimming Scheme is an intensive learn to swim program which develops water confidence and provides students with basic skills in water safety and survival.

Students who have not reached a satisfactory standard of water safety and survival skills, and are unable to swim 25m confidently unaided in deep water, are eligible to participate in the Special Swimming Scheme. The Scheme focuses on non swimmers in Year 2 and 3 but provides for non swimmers in Years 4 to 6 as well as students with special needs such as new arrivals in Australia and students with disabilities.

Instruction will take place at _________________________ pool under the instruction of qualified teachers.

The Scheme will continue daily for two weeks from ___________ to ___________.
There will be no charge for instruction, however transport will involve a sum of
$ __________ per day and $ ___________ per day for entry into the pool.
The total cost for the 10 day Scheme is $ ______________ .

Each child should bring a swimming costume, a towel, a blouse or shirt and hat and warm clothing on a cool day. Where instruction takes place in an outdoor pool, it is recommended that students use adequate sun protection, eg. an SPF15+ broad spectrum, water resistant sun screen reapplied regularly. A T-shirt or rash shirt is also recommended (pool facility permitting).

If your child is eligible for the Scheme, I invite you to complete and sign the form below and return it to your child's class teacher.

Principal _____________________________ Date _______________

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

RETURN THIS SECTION TO THE SCHOOL BY (Day) ________________ Date ___________

CONSENT FORM

I hereby consent to the attendance of my son/daughter _________________________

at the Special Swimming Scheme classes to be held at _________________________ pool

from __________ to __________.

Travel will be by _____________________ (bus, walking).

Total cost for 10 day program is $ _____________.

Special needs of my child of which you should be aware (eg. allergies, sensory impairment, etc):

___________________________________ ___________________________________

___________________________________ ___________________________________

Signed _________________________________ Date ___________________________
                    Parent/Caregiver

Things you need to know:

1. A standard bus fare of $2.00 applies for the term.
2. All grade teams are coached by members of staff who possess appropriate training/expertise and experience in their respective sports.
3. A member of staff will supervise on each bus.
4. Information concerning the wearing of mouthguards (and other personal protective measures not listed above) will be forwarded to you by the team coach via your son or daughter.
5. Senior students travelling by car will need to complete the attached forms.
6. Considering the nature and level of participation by your son/daughter in their selected sport, you may consider arranging injury/accident insurance cover above that provided by Medicare or your private health cover.