After School Arrangements

 

AFTER SCHOOL ARRANGEMENTS
 
 
 
Child’s Name:………………………………………………………………………………………………. Class:……………….………
 
Please tick one box:
(If more than one box applies please ensure that you give FULL details of your situation in the box below or overleaf)
 
o My child is collected from school by a parent/guardian
o My child has a bus pass and will be collected from school by Dickinson’s/Brylaine
o My child is collected by another adult known to my child (please give name and                                  
    relationship to child in box below)
o My child has my permission to walk/bike home alone

Additional Information:

 
 
 
 

 

 
Signature of Parent/Guardian:……………………………………………………………… Date:…………………………