Excursion Permission Form: Shul Visits 2019

Dear families,

As part of our Jewish Enrichment program, the Blue and Red Room children will be visiting the Chabad Malvern Shul on the 3rd and 4th June for Shavuot. Please scroll down to give your child permission to attend.

Each room will be visit the shul at the following times:

Blue     10.00am - 10.30am 

Red     10:30am-11:00am



Jewish Enrichment Coordinator

Our service has organised an excursion for your child to attend. All of the relevant details are provided for your convenience. The service has conducted an Excursion Risk Assessment which is available for your review up request. For your child to attend, you are required to complete the Authority for Excursion Form. To complete this form, you must be listed on the child's enrolment record as either their parent of an Authorised Nominee.

Time and Date of Proposed Excursion:

Monday 3rd June and  Tuesday 4th June 10:00-11:00am

Cost: N/A

Reason for Excursion: Shul visit to see the Torahs in honour of Shavuot. 

Route to and from: Exit 353 Glenferrie Rd and cross at the pedestrian lights of Glenferrie/High St intersection. Turn right, walk up to 316 Glenferrie Rd, Chabad Malvern entrance.

Destination: Chabad Malvern, 316 Glenferrie Rd, Malvern

Transportation Details (to and from): By foot, holding on to evacuation rope.

The period the child will be away from the Service Premise: Approximately 30mins

Number of adults involved and the anticipated ratio of adults to children: 4 Room Staff Members and additional office staff (approx 3). Minimum Ratio 1:4, up to 1:3.

Number of children involved: Up to 18 children at a time

Proposed Activities: Gather in the shul as the Rabbi shows children where the Torahs are kept. Showing the children an open Torah scroll and holding the pointer to point at Hebrew letters as we sing davening songs.

Items to be taken by the child and provided by the parents: Weather appropriate clothing and, if needed, medication.

Authority for my child to attend the excursion

Child's Full Name:

Person completing this form:

Relationship to child:

I am interested in volunteering to attend the excursion: No Yes


By signing the Authorisation for Excursion Form, I agree to and understand the following:

  • My child has my permission to attend the excursion listed. If the excursion is a regular outing, my child has permission to attend for 12 months after the date listed below.

  • I am listed on the child's Enrolment Form as a parent or Authorised Nominee.

  • I have read all of the details provided by the service and understand that I can access the Excursion Risk Assessment at the service.

  • The contact details, including all emergency contact details, listed on my child's Enrolment Form are up to date. If not, I have provided the updated contact details above.

I agree to and understand the above.



E- signature:
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