Grafton Sports Drop Off

"*" indicates required fields

AUTHORISATION FOR SERVICE TO TRANSPORT CHILDREN

This agreement is ‘Regular Transportation’ per COOSHS Transportation Policy. Regulation 102D

Child's name (Please insert both first & last Name)*

Activity / Sport Details

Activity / Sport

Please Note: If the activity you are wanting is not listed we currently do not drop at this location. Please provide below the activity you would like your child dropped off too and the date and time each week. We will try and accommodate your request and let you know if this drop-off would be possible after we speak to the centre co-ordinator.

Details of Activity / Sport (if not listed)

Activity / Sport starting date (Cannot be today's date)*

Activity / Sport starting time*

Activity / Sport Completion Date*

Cannot be left open past the end of the current year.

When does your child require transportation?*

Monday

Tuesday

Wednesday

Thursday

Friday

Description of proposed pick-up location

Description of proposed drop-off destination*

Authorised Person Details

Name of authorised person at activity/sport who has been informed of this arrangement (Please insert both first & last Name)*

Authorised person contact number*

Agreements & Regulations

REGULATION 102D(4)(F-L)
Means of transport	COOSH company registered vehicle
Period of time during which child is transported	5 – 25 minutes
Anticipated number of children likely to be transported	10
Anticipated number of staff during transportation	1 to 2 (15 children to 1 educator ratio)
Seatbelts or booster seats provided in vehicles	Yes – where seatbelts are fitted, restraints used per COOSHS Transportation Policy
Risk assessment available	Yes – available upon request
Policies and procedures for transporting children	Yes – available on website and at all centres

Agreement*

1. I hereby give permission for my child listed to be transported to activity/sport detailed on this authorisation
2. I authorise for my child to attend their activity with a different instructor, if their usual instructor is absent.
3. I agree that I am listed as an authorised person to give authority for transportation on my child’s enrolment
4. I agree to email Administration at admin@communityoosh.com.au by 2pm the day of the activity/sport that I do not require transportation for any reason, cancelling this arrangement for a day or a specific period.
5. I agree it is my responsibility to source correct information if an activity/sport is cancelled due to inclement weather and email Administration on admin@communityoosh.com.au as soon as possible that I do not require transportation.
6. I understand that my child will be dropped to the stated location on the stated day and time at the discretion of the centre Co-Ordinator if no correspondence has been received to cancel this arrangement
7. I agree that Community OOSH Services are not responsible for locating my child after they have been dropped at the location detailed above after being signed out of the program
8. I agree that I take full responsibility for locating my child

I agree to the above

Parent Details

Parent Name (Please insert both first & last Name)*

Parent Contact Number*

Parent Email*

Parent Signature*