2018

Parental Consent Form

CONSENT

I consent to my son / daughter to join an adult course and accommodation package at Clubclass. I am satisfied that my son / daughter is sufficiently responsible and experienced to assume full and entire responsibility for his / her own safety, wellbeing and behaviour at all time.

THE SCHOOL WILL NOT ACT IN LOCO PARENTIS

The school’s duty of care for my son / daughter shall be no greater than for an adult participant. The school does not and will not act in loco parentis (“in the place of a parent”) with respect to my son / daughter and his / her property. This means that I am entirely responsible for my unaccompanied son / daughter at all times, and for his / her property, even when supervision is provided by Clubclass, whether on its premises or elsewhere

MEDICAL AUTHORISATION

In case of an emergency involving my son / daughter, I understand that every effort will be made to contact me at the contact numbers provided in this consent form. In the event that I cannot be reached, I hereby give my permission to all medical staff which may come in contact with my son / daughter, to secure proper treatment, including hospitalisation, anaesthesia, surgery, X-ray examination and blood transfusions for my son / daughter. The authorisation given by this form is intended to prevent any dangerous delays when emergency treatment is essential. In any event reasonable efforts shall be made by the school to contact the parent or legal guardian before any major treatment administered.

WAIVER OF CLAIMS AND LIABILITY

I am aware that the directors, management or staff of Clubclass of their sub-contractors do not accept responsibility for any loss, injury or damage that the person or property of my son / daughter may sustain while in Malta. I therefore agree that neither I nor my son / daughter can ever make any claim to compensation against the directors, management or staff of Clubclass or of their sub-contractors in respect of any loss, injury or damage incurring in Malta, whether as a result of negligence or otherwise..

CONFIRMATION OF UNDERSTANDING

I confirm that I have read and accepted the Policies and Rules of the school, and that my son / daughter has been informed that violation of these Policies and Rules and/or the laws of the land may result in their expulsion.

I also confirm that I am in receipt of a list of 24-hour emergency numbers which may be used by my son / daughter while in Malta, and that I have passed this information on to him / her, for his / her better guidance and to ensure his / her general well-being is safeguarded while in Malta.

I also confirm I have explained to my son / daughter that he is to keep these numbers on him at all times, even at supervised activities, where he continues to be responsible for him / herself.

Student Details
Name and Surname
Arrival date
Departure date
Parents Details
Mother / Father
Name and Surname
Address
Mobile
email
Family Doctor
Name and Surname
Mobile
email
Student's signature / Mother's signature / Father's signature

This form needs to be submitted together with the following documents:

·  Copy of the student's birth certificate

·  Copies of the parents' passport/ID showing the parents' signature

Today’s Date

EMERGENCY NUMBERS IN MALTA

For any emergency in Malta, (ambulance / police / fire) - dial 112

Clubclass 24-hour emergency number: +356 9972 6789