Zuccoli Primary eNewsletter

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Authorisation for alternate person to collect child from Preschool

Some families need to make alternative arrangements for the collection of their child from preschool. If someone other than an emergency contact is to collect your child from preschool, please fill in the following form.

Name of child *

As the Parent/Carer of the above listed child, I have made alternate arrangements for my child to be collected from preschool by:

I give permission for information regarding my child to be communicated to the person collecting my child. *

Yes

Contact number of the person collecting my child *

Digital Signature *

Undo

Clear

Write your signature above the line

Parent/Carer's Name: *

Date *

Please ensure the nominated person collecting your child has proof of identification upon collection.

Please specify if this arrangement is only for certain days/dates. *