EOTC Consent Form Education Outside the Classroom (EOTC) Blanket Consent FormThis EOTC form is to cover events that occur during a school day and conclude prior to approximately 6.00pm. Our local walking trips/visits consent relates exclusively to those that fall in the 6km radius of the school site. Further, where an event involves risk exposure greater than what would typically be the case at school, such as adventurous activities or hazardous environments or the event continues overnight, specific consent will be required. At the time of our seeking any further consents you will also be asked to update the health and contact information held by school. It is important that this form is completed at the start of each year for all students who will be participating in EOTC events (as described above). Details on this form will remain confidential to school staff, contractors and volunteers associated with supervising activities on EOTC events. Please note that it is very important that student details such as health information and emergency contacts are kept up to date with the Newton Central School office. Privacy Statement: Please note: the personal information being collected on this form is for the purpose of running EOTC events. It won’t be used or disclosed for any other purpose except in accordance with the Privacy Act 1993. You have the right under that Act to access and seek correction of the information from the school. Student InformationName* First Last Year* Medical Consent In an emergency the school will make every effort to contact me, but may act on my behalf to ensure the safety of my child I agree that if prescribed medication needs to be administered, a designated adult will be assigned to do this. I will ensure that prescribed medication is clearly labelled, securely fastened and handed to the designated adult with instructions on its administration. I will inform the school if there are any changes in medical information I have provided between the completion of the Newton Central School Student Health Profile and the commencement of any EOTC event organised by the school. I understand that in the event of a medical incident, the school will contact me directly. Any medical costs not covered by ACC or a community service card will be paid by me. Full Name of Parent / Caregiver* First Last Parent / Caregiver Email* Signed by Parent / Caregiver* Reset signature Signature locked. Reset to sign again Student Contract for Years 3-6 StudentsTo be read and signed by all participating students I understand that any EOTC event is an opportunity for me to learn, practise skills and gain attitudes and values in an environment outside the classroom. I realise that this requires me to take on genuine responsibility for my own learning and the safety of myself and that of others. I agree to do the following to make this happen: - Right place, right time and doing the right thing - Show respect, courtesy and consideration for others - Follow the rules and instructions of staff and other supervisors at any event - Take part in all activities - Look after myself and my personal belongings - Accept the rules set by the school for any event Signed by Student* Reset signature Signature locked. Reset to sign again Parental Consent I agree to my child taking part in EOTC activities as described in the information provided for each event. I acknowledge the need for them to behave responsibly. I understand that there are risks associated with involvement in Newton Central School’s EOTC events and that these risks cannot be completely eliminated. I understand Newton Central School and/or outside provider will identify any foreseeable risks or hazards and implement appropriate procedures to eliminate, isolate or minimise those hazards so that my child is as safe as practicable. I understand that my child will be involved in the development of safety procedures. I will do my best to ensure that my child follows these procedures. I acknowledge that in order to gain a better understanding of the risks involved I am able to ask any questions of the teacher in charge of the event about the activities in which my child will be involved. I recognise that participation in such activities is voluntary and not mandatory. My child and I both understand that they may withdraw from the activity if they feel at risk and that this decision must be made in consultation with the person in charge of the activity. I understand that Newton Central School nor the EOTC provider will accept responsibility for loss or damage to personal property (either my child’s property or damage to other’s property caused by my child) and that it is my responsibility to check my own insurance policy. I accept that I may be charged for items damaged by my child (either deliberately or as a result of negligence) during the course of the EOTC event. If my child is involved in a serious disciplinary incident that threatens the safety of themselves or others, or compromises the integrity of the event, he/she will be sent home at my expense and no refund for the event will be available. I give permission for photographs or video images of my child to be used by the school or the EOTC provider* Yes No Signed by Parent / Caregiver* Reset signature Signature locked. Reset to sign again
Education Outside the Classroom (EOTC) Blanket Consent FormThis EOTC form is to cover events that occur during a school day and conclude prior to approximately 6.00pm. Our local walking trips/visits consent relates exclusively to those that fall in the 6km radius of the school site. Further, where an event involves risk exposure greater than what would typically be the case at school, such as adventurous activities or hazardous environments or the event continues overnight, specific consent will be required. At the time of our seeking any further consents you will also be asked to update the health and contact information held by school. It is important that this form is completed at the start of each year for all students who will be participating in EOTC events (as described above). Details on this form will remain confidential to school staff, contractors and volunteers associated with supervising activities on EOTC events. Please note that it is very important that student details such as health information and emergency contacts are kept up to date with the Newton Central School office. Privacy Statement: Please note: the personal information being collected on this form is for the purpose of running EOTC events. It won’t be used or disclosed for any other purpose except in accordance with the Privacy Act 1993. You have the right under that Act to access and seek correction of the information from the school. Student InformationName* First Last Year* Medical Consent In an emergency the school will make every effort to contact me, but may act on my behalf to ensure the safety of my child I agree that if prescribed medication needs to be administered, a designated adult will be assigned to do this. I will ensure that prescribed medication is clearly labelled, securely fastened and handed to the designated adult with instructions on its administration. I will inform the school if there are any changes in medical information I have provided between the completion of the Newton Central School Student Health Profile and the commencement of any EOTC event organised by the school. I understand that in the event of a medical incident, the school will contact me directly. Any medical costs not covered by ACC or a community service card will be paid by me. Full Name of Parent / Caregiver* First Last Parent / Caregiver Email* Signed by Parent / Caregiver* Reset signature Signature locked. Reset to sign again Student Contract for Years 3-6 StudentsTo be read and signed by all participating students I understand that any EOTC event is an opportunity for me to learn, practise skills and gain attitudes and values in an environment outside the classroom. I realise that this requires me to take on genuine responsibility for my own learning and the safety of myself and that of others. I agree to do the following to make this happen: - Right place, right time and doing the right thing - Show respect, courtesy and consideration for others - Follow the rules and instructions of staff and other supervisors at any event - Take part in all activities - Look after myself and my personal belongings - Accept the rules set by the school for any event Signed by Student* Reset signature Signature locked. Reset to sign again Parental Consent I agree to my child taking part in EOTC activities as described in the information provided for each event. I acknowledge the need for them to behave responsibly. I understand that there are risks associated with involvement in Newton Central School’s EOTC events and that these risks cannot be completely eliminated. I understand Newton Central School and/or outside provider will identify any foreseeable risks or hazards and implement appropriate procedures to eliminate, isolate or minimise those hazards so that my child is as safe as practicable. I understand that my child will be involved in the development of safety procedures. I will do my best to ensure that my child follows these procedures. I acknowledge that in order to gain a better understanding of the risks involved I am able to ask any questions of the teacher in charge of the event about the activities in which my child will be involved. I recognise that participation in such activities is voluntary and not mandatory. My child and I both understand that they may withdraw from the activity if they feel at risk and that this decision must be made in consultation with the person in charge of the activity. I understand that Newton Central School nor the EOTC provider will accept responsibility for loss or damage to personal property (either my child’s property or damage to other’s property caused by my child) and that it is my responsibility to check my own insurance policy. I accept that I may be charged for items damaged by my child (either deliberately or as a result of negligence) during the course of the EOTC event. If my child is involved in a serious disciplinary incident that threatens the safety of themselves or others, or compromises the integrity of the event, he/she will be sent home at my expense and no refund for the event will be available. I give permission for photographs or video images of my child to be used by the school or the EOTC provider* Yes No Signed by Parent / Caregiver* Reset signature Signature locked. Reset to sign again
