Year 11 Retreat – 2021 Parent/Carer Name: First Last Student Name: First Last Parental Consent:* I give consent for my daughter to participate in the Year 11 Retreat at The Collaroy Centre, 22 Homestead Avenue, Collaroy from Monday 1 February until Wednesday 3 February. Medical Information*It is important that any updates to your daughter's medical record on the College website are made before the start of Term 1. I acknowledge that my daughter's medical information on the College website must be up to date as at 28 January 2021. Provision of Medication (check all that apply)*Please identify the medications you authorise College or camp staff to provide to your daughter whilst on retreat. Select All Paracetamol (i.e. Panadol) Ibuprofen (i.e. Nurofen) Antihistamine (i.e. Zyrtec) I do not give permission for any medication to be provided to my daughter by attending staff. Tetanus Inoculation*Is your daughter's tetanus inoculation current? Yes No Unsure Emergency Care Plan*Please select the appropriate option below for your daughter. My daughter suffers from asthma and/or anaphylaxis and I acknowledge that her current emergency plan must be provided to the College prior to the start of retreat. My daughter does not suffer from asthma and/or anaphylaxis. Swimming Ability*Please identify your daughter's swimming ability by selecting one of the below options. Please note that this retreat involves ocean swimming, not pool swimming. My daughter can confidently swim 50 metres My daughter can confidently swim 25 metres My daughter is not a confident swimmer My daughter is a non-swimmer Additional informationPlease provide any other information that you feel is pertinent to your daughter's participation at the retreat.Birthdays:My daughter's birthday will occur while at the retreat. Her birthday is on: Date Format: DD slash MM slash YYYY
