STUDENT INFORMATION SHEET
Each year we need to update our student records. It is very important that you complete the following three pages (front & back of this sheet, as well as the media permission sheet) and return to your child’s teacher as soon as possible (even if your details have not changed).
Child’s Name ______
Class 2011 ______
Is the student’s main language, spoken at home, English? YES NO
This section is for the parents/carers with whom the student normally lives.
Parent/Carer 1 ______
Relationship to student ______
Phone: Home ______
Work______
Mobile______
Parent/Carer 2 ______
Relationship to student ______
Phone: Home ______
Work______
Mobile______
Correspondence
Mailing Title______
Residential Address______
______
Mailing Address______
______
Email Address______
Family Details
With whom does the child live?______
Details of parent/carer not residing with the student:
If applicable, copies of any relevant family law or other court orders must be provided.
Name______
Relationship to student ______
Phone: Home ______
Work______
Mobile______
Address______
______
Emergency Contacts
(Please ensure that the Emergency Contact People are aware that they are nominated on the child’s records at this school).
Emergency Contact Name ______
Phone______Relationship to family______
Emergency Contact Name ______
Phone______Relationship to family______
Doctors Name ______
Phone______
Medicare Number ______
Allergies______
See Asthma Form attached
Medical Conditions______
Parent/Caregiver Signed______
Date ______
Print Parent/Caregiver Name ______
Please advise the school as soon as possible if there are any further changes during the year.
Newsletter
As conservation becomes a priority at our school we ask you to please take part by electing to have the newsletter emailed to you.
☐ No, please send the newsletter home with my child.
☐ I would like to be on the 2011 email distribution list. Please send the newsletter electronically to:
Option 1: ☐ Email your details to:
Simply type the word ‘newsletter’ in the subject and include your name, your child’s name and class in the body of the email.
Option 2: ☐ Yes, please send the newsletter electronically to:
Your name: ______
Email address: ______
LOCAL WALK PERMISSION NOTE
During the course of the term, teachers may choose to take the children for walks around the local area as a component of teaching and learning programs. They are a wonderful way to develop an understanding in the children that learning is something that happens outside the classroom as well as in it. Parents would be informed prior to these local walks and are always welcome to assist as a parent helper.
I give permission for my child______of class______
To participate in local walks around the Orange Grove area. I understand that this would be under teacher supervision and that I would be aware of these activities prior to the date of the activity.
Signed:______Date:______
SUNSCREEN USE
Although OGPS supports SunSafe practices there are occasions when activities occur outside. Sometimes children are not prepared with sunscreen but it is available at the school.
I give my permission for sunscreen to be administered to my child ______of class ______when required.
Signed:______Date:______
Yrs 4-6 only Walking Home from School
We are aware that parents of students in Yrs 4-6 may allow their children to walk home from school by themselves. If your child has permission to do so please complete the form. We will not allow them to walk on their own without written consent
My child ______of class ______has permission to leave school at 3pm and walk home without an adult.
Signed:______Date:______
Media Permission
I hereby give permission for my child ______
of class ______to participate in any media event organised in the school in the year 2011.
I consent to the publication of photographs or film of my child in material prepared solely for the publicity of the school.
I understand that the photograph/film may be published:
·on the Orange Grove Public School Website and hence can be accessed on the World Wide Web.
·via video conferencing when my child participates in the Connected Classrooms Program.
·in the school newsletter.
I understand that any such activity will be authorised by the Principal.
Parent/Caregiver Signed ______Date ______
Changing Permission
I understand that if I wish to alter the media consent above I will need to notify the school in writing.
Parent/Caregiver Signed ______Date ______
COLLECTION OF STUDENTS FORM SCHOOL
We are aware that throughout the year some students will be collected from school by a person who is not their primary care. To assist us when dismissing your children at 3pm could you please list any adults who have permission to collect your child.
Name / Contact number / Relationship to studentINTERNET USAGE