St Brigid’s College

PRE -KINDERGARTEN – YEAR 12

LESMURDIE, WESTERN AUSTRALIA

Parent Excursion Consent Form

Form to accompany excursion

Student’s Name ___________________________________________ Year Level ____________

Address ______________________________________________________________________________________________

Telephone (Home) ________________________________ (Mobile) ______________________________________

Title of Excursion: Kalamunda History Village

Education purpose of the program:

Details of supervising staff:

Date of Excursion: 12th September 2018 Departure: 9:00am Return: 2:15pm

Dress: Students are to wear clothes from 1907-1970. (Pictures attached to form)

Food: Students are to have their recess and lunch in two separate bags with their name first
and last name clearly labeled on them.

Mode of Travel: Students will be travelling from school to the Kalamunda History village and
return by Bus West. Cost: $8.00
_____________________________________________________________________________________________________________
Parent consent
I have read all of the information provide by the school in relation to the excursion

I give permission for daughter/ son _______________________________________ (full name) to attend.

Parent ________________________________________________________________________ (full name)

Signature ______________________________ Date__________________________________________

In case of emergency I can be contacted on ________________________________________________________

Parent consent OFFICE COPY

I have read all of the information provided by the school in relation to the excursion

Date of excursion: Departure: Return:

I give permission for my daughter/son ___________________________________ (full name) to attend

Parent ____________________________(Full name) Signature___________________________ Date____________

In case of Emergency I can be contracted on ______________________________________________________

Clothing ideas: