Relationship to Child. Date.....................................................
Relationship to Child. Name: ………………………………………………….................. Telephone: ......………………………………….............................
Relationship to Child. 2. Relationship to Child: Title: MRS MR MS MISS Title: MRS MR MS MISS Surname: Surname: First Names: First Names: Home Phone: Home Phone:
Relationship to Child. Child(xxx)’s Doctor: ………………………………………....................... Telephone: .................…………….……….............................
Relationship to Child. Date: ......................................................................... Parent/Carers signature................................................................
Relationship to Child. I understand that I must deliver the medicine personally to the school office or my child’s teacher.
Relationship to Child. I understand that I must deliver the medicine to school personally. I accept that this is a service that the school is not obliged to undertake. I understand that I must notify the school of any changes in writing.
Relationship to Child. CHILD’S AGREEMENT
Relationship to Child. Any reference to parent/s contained in this contract shall mean both parents, i.e. both the mother and the father or legal guardian/s
