Millisle Primary School & Nursery

Peace Plus Programme - ASPIRE - P4

Four visits have been organised through the Peace Plus Programme for P4 in conjunction with pupils from West Winds, St Mary's Portaferry and Kircubbin Integrated Primary Shools. The visits are as follows: 'Blair Mayne' - March; 'West Winds Primary School' - April; 'Windsor Park' - May; 'We are Vertigo', Belfast - June.

Child's Forename

Child's Surname

I consent to my child taking part in the trip to Blair Mayne in March.

I consent to my child taking part in the trip to West Winds Primary School in April.

I consent to my child taking part in the trip to Windsor Park in May.

I consent to my child taking part in the trip to 'We are Vertigo' in June.

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 child returning home from the visit due to unforeseen circumstances.

I agree to my child 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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Peace Plus Programme - ASPIRE - P4

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