Professional Documents
Culture Documents
Emergency Contact 2012-1
Emergency Contact 2012-1
STUDENTCONTACTDETAILS2012
DearParents
As our student records need to be updated on a regular basis, we request that all families complete the
followingdetailsandreturntotheschoolofficeNOLATERTHANFRIDAY10thFEBRUARY2012.
FAMILYNAME:_________________________
STUDENTNAME
DATEOFBIRTH
CLASS
________________________
____________
_____
________________________
____________
_____
________________________
____________
_____
________________________
____________
_____
Address:..
HomePhoneNo:..
MothersName:..WorkNo: Mobile:.
FathersName:WorkNo:.. Mobile:.
OtherEmergencyContactName:.. Number:..
(OTHERTHANPARENT)
DoctorsName:. Number:..
Medicalproblemsofwhichtheschoolshouldbeaware:
CONSENTTOPUBLISH
Pleasecompletethissectionandclearlyindicatewhetherconsentisgiven.Thankyou
IherebyCONSENTformychild/childrensname(whoarelistedabove)andphotographtobepublishedin
the Helensburgh Highlights and other school publications including School Website, Blog, Internet, Annual
SchoolReportandSchoolMagazine.
Note:PleasebeawarethatsurnameswillnotbepublishedontheInternetandnamesareneverpublished
withanaccompanyingphoto.
Forexample:Unlessconsentisgivenyourchildsnamewillnotbepublishedinourschoolnewsletter.
Signed:_____________________________
Date:________________
(Parent/Guardian)