MEDICAL AND DIETARY INFORMATION
|Visual Impairment||Hearing Impairment||Asthma||Fainting||Headaches||Bed wetting/incontinence|| |
PARENT/GUARDIAN CONTACT DETAILS
If your answer above is NO, please indicate the number of the person who can speak English in case of an emergency.
Country Cousins takes photographs and videos of individuals and groups of students for use in its publicity material and in social media (Facebook and Instagram mainly). Please tick the boxes below if you are willing for the Student to be included in such group photographs/videos.
Students will have the option to go to some activities outside the school. The student will be accompanied by Country Cousins staff, and measures will be in place for their safety.
There are times where the students have additional freedom, for example when an outing to go shopping. Please tick the boxes below accordingly.
You must sign and agree before submitting this booking form.