Hume Valley School : On-Site Attendance Application Form- Term 1 2021

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On-Site Attendance Application- Term 1 2021

The Victorian Government has stated that all students who CAN learn from home MUST learn from home.

Please tick all of the boxes below to indicate that you understand the requirements and potential risks of on-site attendance during term 1 of 2021

Student Name: *

Student's Sub-School & Classroom Teacher *

I understand the following: Please make sure all boxes are selected before submitting this form *

I am requesting that my child attend on-site schooling because my child is not able to be supervised at home and no other arrangements can be made.

I confirm that there is no-one working or studying from home, there is not another adult or person able to supervise the child at home / or any other arrangements can be made for my child at home on the requested days / times

I understand that Hume Valley School will provide as far as possible a clean, hygienic and safe learning environment for my child, however the School cannot guarantee that my child will not be exposed to the COVID-19 virus whilst in attendance as there will be children and adults from a variety of homes present in the one location.

I understand that my child will need to, as far as possible, abide by all physical distancing, safety and hygiene requirements whilst in attendance, and if they do not, I may be required to collect my child immediately.

I understand that as the school will have a limited number of staff available, my child will be supervised in their remote learning by a Teacher or Education Support Staff member who volunteers to be at school.

I understand that my child will be engaging in the same remote learning plan at school, as all other students who are learning from home, and that they will not be supervised by the same staff each day.

By submitting this form, I declare that my child is well and I will collect my child as soon as possible upon the request of the school if my child becomes unwell.

Required

Dates Required- Week 4 - Starting Monday 15th February 2021

ALL DAY

Monday

Tuesday

Wednesday

Clear selection

Transportation To/From School:

Please indicate how your child will be travelling to and from school on the days that school supervision is required.

Transportation To/From School or the above selections: *

Parent/ Carer to provide transport

Allocated DET School Bus Service (not available Monday)

Mother / Carer : Name and Contact Number *

Mother / Carer: Essential Worker Occupation & Work Contact Number: *

Mother / Carer: Please list days of the week you are employed at your work location. *

Father / Carer : Name and Contact Number

Father / Carer: Essential Worker Occupation & Work Contact Number:

Father / Carer : Please list days of the week you are employed at your work location.

Emergency Contact Details (Names and Phone Numbers): *

By selecting the "YES" checkbox, you are signing this agreement electronically. *

YES

Submit

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