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Murray Upper State School

Parent STEM EVENT Consent
During Science week, Year 4 students from Murray Upper State Primary School will become Lego Masters
designing and building a Dam made from Legos. The Year 4 students will be set the task of designing, creating
and testing their engineering skills to create the most effective water holding facility in response to the Central
Queensland drought. We will be accompanied by Australian Dams and Water consultant, David Steward. David
will be holding a presentation on the effects of drought and the important roll Dams play in our ecosystems. The
presentation will be the inspiration for our engineers to help solve central Queensland’s water crisis. The event
will be held in the library on Friday 16/08/19 from 1:30pm- 3pm. Families are encouraged to come along, there
will be light refreshments available with a student presentation of their designs.

As this is a Lego master’s event, parents are advised that there will be small parts/ Legos. This can be a choking
hazard for small children, all children attending the event will require full parent supervision. We will have safety
measures in place to prevent such an incident but would like families to be aware of the risk.
Kind Regards
Peri Baynton

Name of school:

Murray Upper State School

Title of event:
Murray Upper Lego Masters

Educational purpose of the program:

STEM (science, technology, engineering and mathematics.

Details of supervising staff: Costs: Free, light snacks provided

Teacher: Peri Baynton/ Jodie Macdonald
Aide: Lisa Smith/ Jenny Pass Mixed wraps
Volunteers: Jane Tims, Sue Black Mixing sandwiches
Guest speaker: David Steward Fruit salad
Assorted cakes and biscuits
Allergy and Gluten free options

Name and contact details of the 24-hour

school emergency contact:
John Wright: 0458383929
402999383
Johnwright@hotmail.com

Please list any Dietary requirements

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Activity arrangements:
1:30 pm Arrival and David Steward presentation

1:40 pm Task instructions presented by David Steward

1:45-2:45 Designing, creating and testing / light refreshments available

2:45-3: 00 pm Student presentation and departure

© State of Victoria 2009 Published Sept 2009

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A risk management plan for this program has been developed by staff and is available for parents to review on
request.

Student behaviour
‘I understand that in the event of my child’s misbehaviour or behaviour that poses a danger to himself/herself or others
during the event, he/she may be sent home. I further understand that in such circumstances I will be informed and that
any costs associated with his/her return will be my responsibility.’

ICT/Photograph consent
‘I agree to my child using the Internet and computer network in accordance with the same Internet student user’s
agreement that applies at their current school.’ [Strike out if you do not consent]

‘I also consent to my child being photographed and/or visual images of my child being taken during activities by the school
for use in the school’s publications, school’s website or for publicity purposes without acknowledgment and without being
entitled to any remuneration or compensation.’ [Strike out if you do not consent]

Cancellations or Alterations
‘I understand that the principal may need to cancel or alter excursion arrangements at short notice, due to circumstances
beyond the control of the school, and while the principal will try to minimise inconvenience or financial losses to parents,
these may be unavoidable.’

Consent for emergency transportation

‘In the event of an emergency I consent to my child being transported in a privately-owned vehicle driven by a member of
the supervisory staff listed above.’
Student accident insurance
The Department of Education does not provide student accident cover. Parents may wish to obtain student accident
insurance cover from a commercial insurer, depending on their health insurance arrangements and any other personal
considerations.

Parent consent

I have read all the above information provided by the school in relation to the Lego Masters STEM event, including any
attached material.

I give permission for my daughter/son_______________________________________ (full name) to attend.

Parent/guardian: _______________________________________ (full name)

_______________________________________ (signature) ____________ (date)

In case of emergency I can be contacted on:

____________________________ OR:

____________________________

Volunteer:

I ____________________ am interested in being a volunteer for the Year 1 Geography field trip to the
Botanical gardens on Thursday 21.02.18 From 830am – 1030 am approximately.
Please indicate preferred contact

Phone: ____________________________Email: _____________________________

For Further information please contact Peri Baynton on peribaynton@fjfjfj.com

Name: _____________________Date: _________________signature____________________

Note: Parents should also complete the ‘Confidential medical information for school council approved school excursions.

Modified for assessment purpose. (Victoria State Government Education and Training. (2019a). Retrieved from
https://www.education.vic.gov.au/school/teachers/studentmanagement/excursions/Pages/outdoorforms.aspx)

© State of Victoria 2009 Published Sept 2009

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