Working Together, Growing Together

For The Calendar

Next Week

Mon. 01 Sept Uniform Shop opens from 9 - 10am

Mon. 01 Sept ‘Flying Start’ 9.30 -11am in Kindy Room

Mon. 01 Sept ‘Kids on Keyboards’ classes

Mon. 01 Sept Boys Hockey K/O CPS V Taree West PS G’brn

Wed. 03 Sept Fathers’ Day Gift Wrapping 11.45 – 1.30pm

Wed. 03 Sept Indigenous Literacy Day

Thu. 04 Sept Pancake Day - Forum fundraiser.

Thu. 04 Sept Fathers’ Day Gift Sales 11.45 – 1.30pm

Fri. 05 Sept Year 5 Assembly Item @ 12.15pm

Coming Up Mon. 08 Sept Uniform Shop opens from 9 - 10am

Mon. 08 Sept ‘Flying Start’ 9.30 -11am in Kindy Room

Mon. 08 Sept ‘Kids on Keyboards’ class

Mon. 08 Sept Year 6 attend Sport & Rec Camp

Tue. 09 Sept SpacExpo @ G’burn for Yrs 3, 4 & 5

Mon. 15 Sept Taster Lessons for Year 6 @ C’well High

Mon. 15 Sept Year 2-6 Social “Sporting Idol’ 6pm – 8pm

Fri. 19 Sept K/1/2 Assembly Item @ 12.15pm

Fri. 19 Sept Last Day of Term 3

Fri. 28 Nov Presentation Evening 7pm CHS Hall Buzzing all Kindergarten Parents! Kindergarten is very busy getting ready for their assembly item at the end of this term! As part of our attire we need many wire coat hangers and old/new black stockings. We will be making our costumes at school in the next few weeks so please start sending these items in.

Thank you very much, Miss Logan and Miss O’Neill Enrolling Now For 2015 If you know of families who are in the process of enrolling children at Crookwell Public in 2015 please encourage them to return their Application For Enrolment Forms to school promptly. This will allow staffing arrangements to be firmly in place for the commencement of the 2015 academic year.

Families new to the school community who are considering enrolling students at the school are invited to contact the school on 48321213 to arrange an interview with Mr Atfield, meet the staff, tour the school and receive a Crookwell Public School Information package.

Thank you to the families who have already completed and submitted their child’s application to enrol. Principal’s Award • Isaiah Druett for using his initiative and creating extra

props at home.

Spotted This Week Were …… • Ben Flood for honesty. • Olivia Wong and Isabelle McCormack for thoughtful

actions.

• Victa Woods for being a very honest boy.

• Rick Newman for honest actions.

• Bella Holman for responsible behaviour.

• Jade Smith, Kirrilly Skelly and Georja Seaman for citizenship.

• Trinity Garnham for chivalrous behaviour.

• Kiarna McCarten, Regan Selmes and Isabelle McCormack for helping to keep our playground safe and tidy.

• Emily Newman for offering to help others.

• Chad McDonald for helping keep the playground tidy.

• Ashley McDonald for her mature behaviour.

• Addison Whittington for honesty.

• Claire Collins and Meka Munday for caring for another student’s property.

• Mackenzie Gauci for honesty.

• Charlie Colley for a super job looking after our environment!

• Jack Speer for his kindness towards others.

• Taane-Dean Brown for keeping our room tidy.

• Jarred Croke for assisting with the art clean up.

• Joshua Merryfull for working very hard in mathematics.

• Eboney Handcock for producing clear and concise writing.

• Cameron Herd for his mature and responsible behaviour.

• Emma Robertson, Abby Woods, Kirrilly Skelly, Rhianna King and Issy Snape for completing an important task.

• Zakaia Lewis for thinking ‘outside the box’ in mathematics.

• Jayme Cartwright and Meka Munday for being caring, thoughtful friends.

• Kimberly Allport for keeping the classroom tidy.

• George Lee for giving his best effort in maths.

• Shaymus Woodwell for excellent reading.

• All students in Year 1 and Year 2 for their outstanding behaviour on the ACT History Excursion.

• Students in Year 1 for their insightful answers to the questions discussed on Dawn’s Surprise.

• Blake McCarten for chivalrous behaviour.

• Lachlan Tetley and Hailey Collins for thoughtful actions.

Term 3 Week 7 29th August, 2014

Working Together, Growing Together

A big thank you to all students and families that supported Daffodil Day! There was a terrific response from the students with lots of bright yellow throughout the school. An amazing $208 was raised to assist the cancer council in their research efforts. Students also participated in peer support activities that included making daffodils and playing yellow games.

Amazing Anton dressed as a daffodil on ‘Daffodil Day’.

Emma, Shaymus, Rhiannon, Makayla and Sophie showed their support of this very worthy cause as they worked as a

team to make ‘daffodils’.

Jack and Victa taking a moment to quench

their thirst on ‘Daffodil Day’.

Darcy, Sebastian, Abby, Kiarna and Meka working on the

daffodils that were later mounted to make a beautiful ‘Daffodil Day’ collage.

Thomas, Isabella, Lillian, Bonita, Grace and Jess working to

make daffodils for their ‘Daffodil Day’ collage.

Peer Support Leader Jess, works with Wade, one of the

younger members of her peer support group.

Jayda, Carley, Jack and Mia almost ‘glowed’ in their yellow

outfits.

Working Together, Growing Together

Sharing, Counting, Reading, Singing, Making, and Playing! We are fitting so much into our Flying Start mornings. This week we had time to share with our friends during group activities, we did some counting, read the story “Where the wild things are”, sang many of our favourite songs, made crowns to go with our story AND we even had time to go outside for play with our friends on the fixed equipment.

Cooper Tetley and Mrs Gay enjoy pressing shapes

at the play dough table.

Tynen Long and Alyssa Huang share a laugh at the

animations they have created on the computer.

Jack Haynes uses the blocks to make a

diamond out of two triangles!

Michael Foster and Kiowa Morning make their ‘King of the

Wild Things’ crown using paper, cardboard, glue and scissors.

Dustin Carr sprinkles gold glitter for a

sparkling effect on his crown.

Alyssa Huang and Kiowa Morning are

delighted to be outside on the play equipment.

Working Together, Growing Together

Canberra History Excursion Tuesday 26th August saw Year 1 and Year 2 attend their history excursion to Canberra to visit Calthorpes’ House and Mugga Mugga Cottage to support their knowledge and deepen their enquiry into the History of Past and Present family life. The excursion was split into two separate programs with Year 1 attending Calthorpes’ House and Year 2 attending Mugga Mugga Cottage.

Students in Year 1 delved into the life of Dawn Calthorpe and experienced life as a seven year old living in 1931. This program was based on the story of Dawn’s Surprise about Dawn’s older sister’s birthday. Students explored the house, looking at all the possible hiding locations Dawn chose to hide a birthday present for her sister Del, ending up in Del’s room, where she hid the present in Del’s baby’s cradle.

Outside the house, the students participated in old fashioned games such as hopscotch and the good old ‘egg and spoon race’. The truly unique feature of Calthorpes’ House is that everything in the house actually belonged to Dawn and her family.

The Year 2 program was held at Mugga Mugga Cottage where the students learnt about the Curley family and their three daughters Sylvia, Ada and Evelyn and their time on the Mugga Mugga Property in 1913. They learnt how people lived in the past and how landscapes change over time. The students toured the cottage, investigating the building materials, the rooms and their function and then moved to the paddock. In the paddock they collected plant samples to incorporate in their collage and discussed the effect urbanisation has on the landscape.

The bus trip home proved that the children had a truly engaging and exhilarating time as the conversations of what was learnt and what was achieved were ripe, throughout the bus.

Mrs McCormack

Sally our education officer comparing the photos of Dawn

and her sister Del when they were young.

Abby and Billy looking under the bed to

see if Del’s present was there.

Moraig the education officer discussing the history of the Curley family and their day to day lifestyle.

Cody, Jayda, Ashleigh, Isabelle and Olivia standing on the exit to the air raid shelter.

George, Regan and Isabella carefully watching

their eggs, during the egg and spoon race.

Year 2 making their collages.

Working Together, Growing Together

Literacy Celebration To celebrate Literacy Week and International Literacy Day students from Kindergarten to Year 5 will be participating in EAT READ SHARE. This will be an activity which combines the love of reading and sharing of books with peers during a delicious picnic lunch. Year 6 students will be enjoying camp with Year 5 students leading peer support groups in this event.

Each student will need to bring their own picnic lunch, a book they enjoy to share with their peer support group and be dressed in full school uniform with their school hat. This exciting literacy event will be held on Monday 8th September (weather permitting) with Wednesday, Thursday or Friday of the same week as our back up days.

Students in Year 1 – 5 will be walking to Kiamma Creek Park to join in the festivities. Kindergarten will be joining their friends at Crookwell Pre-School to participate in EAT READ SHARE. Years 1 – 5 will be leaving school at 12.15pm and be returning around 1.30pm. Canteen lunches will be delivered when they are ready, to students by school staff. Kindergarten will be joining their friends at pre-school between 12.30 – 1.30pm.

If you wish your child to participate in this celebration please return the permission slip by Friday 5th September.

This excursion involves no cost.

Thank you Jade Logan & Helen Anderson - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Literacy Celebration I give permission for my child _________________________

to participate in EAT READ SHARE on Monday 8th

September (weather permitting) or during the week of 8th –

12th September at Kiamma Creek Park (Years 1-5) and

Crookwell Pre-School (Kindergarten). I understand that my

child will be walking to and from each venue.

_________________________ ____________

Parent/Carer signature Date

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - On Thursday the 4th September the school forum will be holding a ‘Pancake Day’ at lunch time in the canteen. Students will be able to purchase plain pancakes, with or without maple syrup and or ice-cream. The cost of the pancakes will be $1.50 for plain pancakes, $2.00 with maple syrup and $2.50 with maple syrup and ice-cream. All money raised will go towards purchasing a new basketball ring for the primary playground.

Thank you, School Forum A Big Thank you from Year 6 The students in Year 6 would like to thank everyone who bought tickets in their wood raffle which was drawn last Friday. The lucky winners were Ruby and Eboney Handcock. Special thanks go to Shane and Nicole Price who supplied and delivered the wood. Money raised by this raffle will help reduce the cost of Year 6 camp which students will attend in Week 9.

SPACExpo Years 3, 4 and 5 The annual Sports and Culture Expo (SPACExpo) is being held on Tuesday 9th September at Carr Confoy Sports Fields, Goulburn. This event is for Years 3, 4 and 5 students. The students will experience various sports and activities such as wheelchair basketball, touch footy, AFL, lawn bowls, pipes and drum band, kite flying and many more.

The students need to wear their sport uniform, school hat and sunscreen. Students will have a sausage sizzle lunch provided for them but will need to bring their own food for recess and a water bottle. Students with any special dietary requirements will need to provide their own lunch.

Students will be travelling to and from the event by bus at the cost of $8 per child. If you would like your child/ren to participate in this event please fill in the permission note and return it to school with the bus fare by FRIDAY 5th September.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SPACExpo Yrs 3, 4 & 5

I consent to _____________________________________

participating in the SPACExpo on Tuesday 9th September,

2014 at Carr Confoy Sports Fields, Goulburn. Students will

be travelling to and from the venue by bus at the cost of $8

which is enclosed.

Signed:________________________ Date: ______ Emergency Phone contact: _______________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Come to the Assembly Next Friday Year 5 will present their class item at the 12.15pm assembly which will be held in the school hall. You are warmly invited to the assembly to be amazed and entertained. Hope to see you there.

Don’t forget your money for the Fathers’ Day Stall. The stall will operate on Thursday 4th September in the library from 11.45am. There will be a great range of gifts, costing from $1 to $8 each, to choose from. Customers are limited to two gifts each. Medications at School It is a legal requirement that parents and carers complete the attached forms before medications can be administered to their children at school.

Extra paperwork is less convenient I know, but I am sure you will agree if it help to protect our children’s health and safety it is all worthwhile. Glasses Found A pair of copper, coloured glasses has been found. The Specsavers glasses may be claimed by their owner from the school office. Yours in Public Education,

Greg Atfield

Principal

Working Together, Growing Together

P&C Information …………………………… Canteen News ‘Snack Shack’ Roster 2014

Mon. 01 Sept.

Toni Bickley & Kerri Forbes

Wed. 03 Sept.

Kathy Rowe

Fri. 05 Sept.

Karen Arnall, Kristy Grove & Adrian Willis

Mon. 08 Sept.

Sarah Whittington & Mardi Whittaker

Wed. 10 Sept.

Deb Reeves & Amanda Croke

Fri. 12 Sept.

Anna Gardiner, Mel Davis & Sarah Campbell

P&C Fathers’ Day Stall Fathers’ Day is coming up on Sunday 7th September. Again the P&C is having a Fathers’ Day stall with loads of awesome gifts for our students to show the “father” in their life how wonderful they are. The gifts have been purchased but now we need to wrap them and sell them. We are looking for volunteers who would be able to lend a hand to do either or both.

Wrapping will take place on Wednesday 3rd Sept between 11.45am –1.30pm in the library.

Selling will take place on Thursday 4th Sept from 11:45am to 1.30pm in the library.

If you are able to help us out please fill in the slip below and return it to the school office ASAP, or phone the school on 4832 1213 to leave your details. ………………………………………………………………………

P&C Fathers’ Day Stall I _____________________________ would be available to help with the Fathers’ Day stall at Crookwell Public School. I am available on (please tick box) –

Wednesday 3/9/14 between 11.45am - 1.30pm to wrap gifts in the library.

Thursday 4/9/14 from 11:45am -1.30pm to help sell gifts in the library. Daytime contact no._______________________ ……………………………………………………………………...

Community Announcements ………………… The inclusion of any announcement does not constitute or imply endorsement, sponsorship or recommendation thereof by Crookwell Public School.

CROOKWELL JUNIOR HOCKEY EXPRESSION OF INTEREST Crookwell Junior Hockey is seeking interest in a 7 aside mixed hockey family day to be held at the end of September.

Division: Primary, High School and Opens.

Nominations can be accepted as either individual, groups or whole teams.

Players do not have to be registered in the 2014 season to participate, open to everyone.

Anyone who is interested please contact the following by the 7th September: - Carl Banfield 0427264995

- Dave McGregor 0428320851

- Billy Marks 48365224 Crookwell District Junior Cricket Association and Goulburn District Junior Cricket Association Cricket Winter Development Program. Open to any juniors interested in improving their cricket skills, REGARDLESS OF THEIR ABILITY.

Program includes batting, bowling & fielding and is well supervised.

All participants should bring their own gear and a drink

Location: Tully Park Indoor Centre

Friday 12th September

Friday 10th October

Time: 4:30 - 6pm, Cost: $10, $5 for additional siblings

Contact: Garry Mortimer 0403 812 819 tenroh@hotmail.com

CROOKW ELL PUBLIC SCHOOL

43 DENISON STREET CROOKW ELL NSW 2583

PHONE: 02 4832 1213 FAX: 02 4832 1353

Letter to parents and request for support at school of a student’s health condition

Dear Parent/Care Giver

You have indicated that your chi ld has a health condit ion which may require support at school. While the main role of the school is to provide educat ion, we want to work with you to keep your chi ld healthy and safe at school. Please complete the attached form Request for support at school of a student ’s health condit ion , on the basis of information provided by your medical pract it ioner and return it to me . (You may wish to discuss the information required with the medical pract it ioner.) The form includes sect ions where you can request the administrat ion of prescribed medicat ion and/or other assistance.

When I receive your request for support I wi l l need to discuss it with relevant staff and I wi l l then contact you again.

Please advise me at any t ime if there are changes in the information about your child’s health care needs or if I can assist you.

Yours sincerely

Name of Principal………………………………………………..

Signature of Principal……………………………………………

Date…………………….

Page 1 of 4

CROOKW ELL PUBLIC SCHOOL

43 DENISON STREET CROOKW ELL NSW 2583

PHONE: 02 4832 1213 FAX: 02 4832 1353

Letter to parents and request for support at school of a student’s health condition

Request for support at school of a student’s health condition

Information Name of child: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DOB: . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enrolled or Seeking enrolment (t ick) Class ( if enrol led):…………………………. School:……………………………………

Parent contact Parent information (1)

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Relat ionship to chi ld: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Work phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mobi le phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Parent information (2)

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Relat ionship to chi ld: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Home phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Work phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mobi le phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medical pract it ioner contact

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Health/medical condit ion (three l ines) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Could your child experience an emergency reaction in relat ion to this condit ion? Yes No

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CROOKW ELL PUBLIC SCHOOL

43 DENISON STREET CROOKW ELL NSW 2583

PHONE: 02 4832 1213 FAX: 02 4832 1353

Letter to parents and request for support at school of a student’s health condition

Request for administering prescribed medication to the student

(Note: if your child is to take more than one prescribed medication, please attach a separate request for each medicat ion . ) Name of prescribed medication: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prescr ibed for (name of medical condit ion): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prescr ibed dosage: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What are you requesting the school to do? .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Special storage requirements if any eg in refr igerator: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Special instruct ions for administer ing the prescribed medicat ion/s eg must be taken with food or with a glass of water: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Through information you have obtained f rom your doctor or acquired yourself , are you aware of any l ikely side ef fects f rom the prescribed medication? Yes No If Yes, Please provide more information: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I f your chi ld administers his or her own medication at home, do you request that he or she self administers this medication at school? Yes No (Note: The Pr incipal needs to approve a decision for a student to self administer). I f your chi ld self administers the medication at home, what level of support do you provide? (Please describe): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of person who wi l l carry the medication to school: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 3 of 4

CROOKW ELL PUBLIC SCHOOL

43 DENISON STREET CROOKW ELL NSW 2583

PHONE: 02 4832 1213 FAX: 02 4832 1353

Letter to parents and request for support at school of a student’s health condition

Request for other support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Parent or carer signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . . . . . . . .

Privacy notice The information requested on the form is essential for assisting the school to plan for the support of your child’s health needs. It will be used by the NSW Department of Education and Training for the development of arrangements with you to support your child’s health needs. Provision of this information is voluntary. If you do not provide all or any of this information, the school’s capacity to support your child’s health needs could be impaired. This information will be stored securely. You may correct any personal information provided at any time by contacting the Principal.