Comments or questions are welcome. By ticking here I agree to my son/daughter taking part in the Ski Trip to Jasper, Canada from Monday 01/04/2019 to Monday 08/04/2019 and have read the information Student's Name Parent's email address Age on date of departure Home phone: Mother's Work number: Father's work number: Other Mobile numbers available: Emergency contact name: Relationship with emergency contact: Emergency contact address (inc. postcode): Emergency contact daytime phone: Emergency contact evening phone: Emergency contact mobile phone: Does your son/daughter have asthma, a chest complaint, diabetes, eczema, epilepsy, faints, hay fever, a heart condition, migraine, nervous disorders, nose bleeds, phobias, any other illness or disability? No Yes If yes, please give details: Is your son/daughter allergic to anything? (Antibiotics, skin plasters, any particular food or drug, etc.) No Yes If so, please give details: Is your son/daughter receiving any medical treatment at present?: No Yes If so, please supply details: Has your son/daughter suffered from or had contact with any infectious/contagious diseases within the last month? No Yes Disease details: Please note that it may be necessary to obtain a medical certificate confirming that your son/daughter is fit to travel. Please check with your GP which immunisations are required for the country or countries to be visited. Please list those received with dates: : Note : Travelling abroad: if your son/daughter wears contact lenses, he/she is also advised to take a pair of spectacles. Please record below any further information about your son's/daughter's health which is relevant to the visit. : Please inform School if there are any changes to the above information before departure. By ticking here, I agree to my son/daughter receiving medication as instructed and any emergency dental, medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities present. I understand the extent and limitations of the insurance cover provided. Please note that this form must be signed by someone who has parental responsibility as defined by the Children's Act 1989.: Although a printed name is sufficient here, you will be asked to sign a hard copy at a later date. Country to be visited: CANADA Passport number: Expiry date: Please indicate if your child would like to ski or snowboard : Ski Snowboard Please indicate ski / snowboard abiliity D - Absolute beginner Never Skied or boarded before C - 1-2 weeks experience can Snow plough B - 1 Months Experience can make Parallel turns A - Advanced Skier/Boarder UK Shoe Size: Weight in kg: Height in cm: Helmet size in cm (measure around the head with a tape measure): I understand that my son/daughter must wear a ski helmet, when skiing or boarding I understand and accept the code of behaviour below. I will: a) listen to and immediately obey instructions from members of staff / hotel personnel / instructors / airline personnel. b) behave in an appropriate manner around the resort , be punctual for activities and NOT go out ingroups of less than 4. c) behave in a courteous and respectful manner at all times. d) make myself aware of fire exits in all buildings that we stay in. I will not: a) bring, buy or use cigarettes, alcohol or drugs. b) behave in such a way as to endanger myself or others. I have discussed the Code of Conduct with my son/daughter. I understand that if the Head has reason to think that he/she will not observe the Code of Conduct, he/she will not be allowed to participate in the visit. I also understand that he/she may be returned home at my expense if he/she does not observe the code. I agree to my son/daughter taking part in the above visit and agree to his/her participation in all or part of the activities proposed. I have ensured that my son/daughter understands it is most important for his/her safety and the safety of the group that the rules and instructions given by the staff in charge are obeyed. I note that, once I have committed to a place on this trip for my son/daughter, money cannot be refunded. If the School can recover any monies, I would naturally be reimbursed. If you have anything you wish to discuss before submitting this form, please contact Mr Amin. By ticking this box, I confirm that I have read all the information above and both myself and my son/daughter agree to the terms and conditions set out above. We would like to remind all parents and students that the trip is an exciting opportunity, however, students must bear in mind their behaviour and work ethic MUST BE OF A HIGH STANDARD if they are to maintain their place on the trip.