Excursion Permission Form: Shul Visit 2016

Dear families,

As part of our Shavuot learning, each class will be visiting the Chabad Malvern Shul on Monday 29th May in honour and in preparation for Shavuot.


Sarah & Reuvi

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:

Shavuot Shul Visits: Monday 29th May 4:15pm -5:00pm

Cost: N/A

Reason for Excursion: Shul visit to see the Torahs.

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.

The period the child will be away from the Service Premise: Approximately 45mins

Number of adults involved and the anticipated ratio of adults to children: 6 Staff Members. 1:6

Number of children involved: Up to 20 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:
Sign on the line with your mouse or finger