Form SOE3: Parental consent for off-site activities (London Trip 2023)

Dear parents/carers,

You have already received details about our forthcoming visit or activity. Please complete and return this form giving your consent for your child to take part in this activity.

Activity
Year 5 visit to London

Dates and times

This year, the trip will be on Wednesday, 21st June.

We will be leaving Teignmouth Train Station (not school) at 5.45 am and will return for about 10.30pm, depending on traffic.

First Name*

Last Name*

Date of birth

Special details

Please detail any information about your child’s health which may need special attention, but does not prevent them from taking part should be noted below. (For example; any allergies, any medication needed and the dosage, travel sickness, diabetes, asthma or epilepsy?)

Has your child had any relevant recent illness?*

Does your child have any specific dietary requirements?*

Do you have any additional comments?

Name of Parent/Guardian*

Address*

Telephone Number*

Approximate date of last tetanus injection:

I would like my child to take part in this visit or activity and having read the information provided agree to him/her taking part in the activities described.
I consent to any emergency medical treatment required by my child during the course of the visit.
I confirm that my child is in good health and I consider him/her fit to participate.