Education Outside The Classroom (EOTC) Consent Form

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Privacy Statement:
Please note: the personal information being collected on this form is for the purpose of running EOTC events. It will not be used or disclosed for any other purpose except in accordance with the Privacy Act 1993. You have the right under that Act to access and seek correction of the information from the school.

Please complete this form to allow your young person to attend EOTC at Christchurch Girls' High School / Te Kura o Hine Waiora.

Submission of this form signifies agreement to the clauses in the Medical Consent and the Student and Parent/Caregiver Agreement (see these here https://bit.ly/3379DnW) by both parent/caregiver and student.

Student's Surname *

Student's First Name *

Student's year level in 2023 *

Year 9

Year 10

Year 11

Year 12

Year 13

Student's Cellphone number *

Is your child able to swim? Please note - this does not remove the need for group leaders to ascertain for themselves the level of the student’s swimming ability. *

Yes

Don't know

Is your child confident in water *

Yes

Don't Know

Parent/Guardian's name *

Parent/Guardian's emergency contact number *

I have read and agree to the medical consent *

Yes

I have read the Student and Parent/Caregiver Agreement and have discussed this with my daughter *

Yes

I agree to the Student and Parent/Caregiver Agreement *

Yes

Submit

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