STUDENTS DETAILS

Students Name *

Date of Birth *

Parental Agreement for the year *

I / WE GRANT PERMISSION FOR THE ABOVE-MENTIONED STUDENT TO:

1. Travel on the college bus with a staff member who holds a current & correct license *

YesNo

2. Travel on public transport to and from school if needed (students must use the most direct route available) *

YesNo

3. Travel on Public Transport straight from school to Sports or Extra curricular based activities with permission from management and parental approval *

YesNo

4. Walk to and from the local shopping district unsupervised, on permitted days (Wednesday, Friday, Saturday and Sunday) in a group of 2 for a maximum period of one and a half hours *

YesNo

5. Attend college outings away from the college *

YesNo

6. While on certain outings (shops etc), unsupervised for periods but always in a group of 2 *

YesNo

7. Go to the beach and swim in the ocean (between patrolled lifesaving zone) with minimal supervision *

YesNo

8. Go to the KSSHS swimming pool with staff supervision. *

YesNo

9. Travel on public transport at any time to and from outings with staff supervision *

YesNo

10. Ride a bicycle to and from school (with helmet) without staff supervision. *

YesNo

11. If unable to organise a lift or the college can not transport, walk to and from local medical appointments with one other student *

YesNo

12. On occasions that my child may need to use Public Transport, Taxi or Uber and with management and full parental approval and no other available transportation options are available, I will allow my child to use these transportation modes (please note: college prefers year 7s , 8s , 9s and 10 students be picked up and signed out by an approved host) *

YesNo

Please note: The College prefers that parents make arrangements for students to be picked up from the College and returned immediately after training, games, or any extracurricular activities by friends, family, the Coach, or other responsible adult members of the team. Any other leave arrangements must be cleared by management before leave may take place

UPPER SCHOOL STUDENTS (YEAR 11'S & 12S ONLY)

Not applicable if your child is in Lower School (years 7, 8, 9, or 10) please just select "No" for each answer

1. Upper School Weekend leave – maximum of 8hrs unsupervised leave on Saturday and Sunday between the hours of 9am and 5pm in a group of 2. *

YesNo

2. Allow my child to obtain a job and work after school or on weekends, as long as it doesn't interfere with the running of the college schedule *

YesNo

Declaration: In granting the above permissions. I / We accept full responsibility and waive any claims against the Board of Management of The Rotary Residential College Inc. or its employees, for any incident resulting from such permissions and agreements. I acknowledge that during these times my child must take responsibility for their actions and act in a way that Rotary Residential College requires at all times. *

Yes

Parent Name *

Parent Name

Relationship with Student *

Relationship with Student

SIGNATURE of PARENT / GUARDIAN *

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SIGNATURE of PARENT / GUARDIAN

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Date *

Date