Permission to Collect

Please list the details of any other person(s) who you authorise to collect your child from St. Mark’s Preschool. Please also indicate whether or not these people are authorised to give permission for other activities in your absence.

When it is necessary to get someone else to collect your child, please let us know as soon as possible. Anyone collecting your child must let a staff member know they are doing so, and may be asked to produce identification.

I give permission for the following people to pick up my child from St. Mark’s Northbridge Kindergarten:

Today's Date

Child's Name

Name of person collecting

Relationship to child

Address of person collecting

Daytime/mobile phone number of person collecting

I give permission for the above mentioned person to

Collect my child Approve administration of medication Be contacted in case of an emergency Approve undertaking an excursion

Parent/Guardian Name

Signature