Authorisation – Excursion

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Authorisation – Excursion

If relevant add below

Note this is a regular outing which means a walk, drive or trip to and from a destination that the service visits regularly as part of its educational program, where the circumstances relevant to the risk assessment are the same on each outing.

Time and Date of Proposed Excursion
__________________________________________________________________________________

Destination (s)
__________________________________________________________________________________

Reason for Excursion
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________


Proposed Activities
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Route to and from venue
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Transportation to and from venue
__________________________________________________________________________________

__________________________________________________________________________________

Period Children will be Away from the Service
__________________________________________________________________________________

Number of Educators Attending 
__________                  Number of Children Attending  __________

Ratio of Educators to children    ____________             Number of Extra Adults Attending  _______

Items Children need to take
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Please complete this section and return by <insert date>

Child’s Full Name __________________________ Your full name ____________________________

Relationship to Child
_______________________  Current Emergency Contact Number __________

Interested in Volunteering to the Attend the Excursion?             Yes                         No

By signing this Authorisation for Excursion, I agree to and understand the following –

  • My child has permission to attend the excursion listed. If it is a regular outing, my child may attend for 12 months after the date listed below, unless I withdraw my consent which I may do at any time
  • I am listed on the child’s Enrolment Form as a parent/guardian or an authorised person named on the enrolment form
  • I have read all the excursion details and understand I can view the Excursion Risk Assessment at the service
______________________________ ______________________________ ______________________________
Signature Name (please print) Date

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