Millisle Primary School & Nursery

Swimming Sessions 2024/2025 Term 1

DATES : Wednesday 18 September – 4 December – 10 WEEKS TIMES : Leave school at 12.30pm Return school at 2.40pm approx. VENUE : Blair Mayne Newtownards TRANSPORT: EANI Bus

Child's First Name

Child's Surname

Class (please select correct class)

I consent to my son/daughter taking part in this.

I confirm to the best of my knowledge that he/she is medically fit to participate.

Any current medical condition ( if none, please state NONE)

Post medical condition e.g. following a medical procedure or illness (if none, please state NONE)

Any medication being taken (if none, please state NONE)

Any other relevant information which may affect his/her participation in the event, including allergy or dietary requirements ( if none, please state NONE)

Parent /Guardian Name

Parent /Guardian Contact Number

Parent / Guardian Name (2)

Parent / Guardian Contact Number (2)

I accept the established code of conduct for the visit and agree to the arrangements relating to my son/daughter returning home from the visit due to unforeseen circumstances.

I agree to my son/daughter receiving emergency medical treatment, including anaesthetic/ blood transfusion, as considered necessary, by the medical authorities present. I understand the extent and limitations of the insurance cover provided.

Completed & Submitted by (Name):

Date

PASSWORD - please type accuarately and exactly as it was sent to you via Dojo

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Swimming Sessions 2024/2025 Term 1

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