EPOSHC Extra Curricular Activity Permission Form Please enable JavaScript in your browser to complete this form.Child's Name *FirstLastExtra-curricular Provider and Activity detailsOrganisation *Contact Name *Contact Number *Type of Activity *Location of Activity *DayMondayTuesdayWednesdayThursdayFridayDate From *Date To *Time From *Time To *Escort to Activity *Provider to CollectEPOSHC to EscortCollection/Pick-up By *Parent/CarerEPOSHCConfirm the following *I have communicated to my child that they are not to leave the service before being signed out by an EPOSHC EducatorI have communicated to my child that when an activity commences immediately after school ends, that they are to go to their EPOSHC sign-in area first to be signed in by an EducatorI have communicated to my child that an EPOSHC Educator will be escorting them to their activity and that whilst on route they will follow the EPOSHC Educators directionsI understand that whilst away from the EPOSHC service and at the activity that my child is not in the care of EPOSHCI understand that responsibility for my child by EPOSHC will resume once my child is collected from the activity at the designated time I understand that if my child is booked into EPOSHC that I will still be charged for the time that my child is away from the serviceI understand to notify the service if this arrangement changes and at that time I will complete a new Extra-curricular Activities Form if requiredI understand that if the information above is altered on the day, the escort will not proceed unless written authorisation is given by the parent/carerI understand I am required to notify the service in writing if my child is no longer attending the activity as detailed aboveParent/Carer AuthorisationName *Signature *Clear SignatureDate *Submit