CONSENT FORMS for _____________________________________ (STUDENT NAME) Following is a standard permission form, which will be used for the duration of your child’s schooling at Eddystone Primary School. RELEASE OF STUDENT WORK/PHOTO FOR PUBLICATION BY MEDIA AND/OR FOR USE ON THE INTERNET I agree to and provide permission for the photographic, video, audio or any other form of electronic recording of the named student to be used by Eddystone Primary School. I acknowledge and agree that ownership of any photographic, video, audio or any other form of electronic recording will be retained by Eddystone Primary School. I authorise the use or reproduction of any recording referred to above for any reasonable purpose within the discretion of Eddystone Primary School without further acknowledgement and without being entitled to remuneration or compensation. I understand and agree that if I wish to withdraw this authorisation, it will be my responsibility to inform Eddystone Primary School via written communication addressed to the Principal. (PLEASE TICK RELEVANT SECTIONS BELOW):
Publish student’s schoolwork on the internet or in media publications
Name the student on the internet/media in direct reference to school activities or schoolwork
Publish a photo or video of the student on the internet or in media publications
Signature of Parent/Guardian ............................................................................ Dated ................./.............. /20 ..........
**PLEASE NOTE: STUDENT ACCIDENT INSURANCE The Department of Education and Eddystone Primary School 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. ACCIDENT DECLARATION In the event of serious illness or injury to my child whilst at school, on an excursion, or anytime whilst in the care of authorised Eddystone Primary School staff, if deemed necessary, I authorise the principal or the teacher in charge of my child to call an ambulance and acknowledge that I am responsible for any costs incurred.. Also, where the principal or teacher in charge is unable to contact me, or it is otherwise impracticable to contact me to: (PLEASE TICK RELEVANT SECTIONS BELOW):
Consent to my child receiving such medical or surgical attention as may be deemed necessary by a medical practitioner
Administer such first aid as the principal or staff member may judge to be reasonable and/or necessary.
Signature of Parent/Guardian ................................................................................ Dated ................./.............. /20 .......... HEAD LICE INSPECTIONS Head lice are common amongst children, and remain the parent’s responsibility to manage. In support of parents, the school may initiate head lice inspections of students throughout the year. The management of head lice works best when all children are involved in our inspection program. The school is aware that this can be a sensitive issue and is committed to maintaining student confidentiality and avoiding potential embarrassment. Before any inspections are conducted staff will explain to all students what is being done and why, and it will be emphasised to students that the presence of head lice in their hair does not mean that their hair is less clean or well kept than anyone else’s. It will also be pointed out that head lice can be itchy and annoying and if you know you have got them, you can do something about it. Volunteers from our school will conduct the inspection of students. The person conducting the inspections will physically search through each student’s hair to see if any lice or eggs are present. Moslem girls will only be inspected in the presence of women. In cases where head lice are found, the person inspecting the student will inform the student’s class teacher and the
