Millisle Primary School & Nursery

Football Tournament - Blair Mayne

Football Tournament - Blair Mayne - 13th January 2025

Child's First Name

Child's Surname

Class (Please select the correct class)

I consent to my child taking part in this event.

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)

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.

Parent / Guardian Name

Parent / Guardian Contact Number

Password - completed forms will only be accepted from parents/guardians using the correct password. The recognised password will be sent to parents/guardians who are connected to Class Dojo. Please type the password as given to you.

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Football Tournament - Blair Mayne

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