Authorised to Collect
Authorised to Collect
Student Name
Student Name
*
First
Last
Year Level
*
Prep
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
How many authorised person/s are you updating?
*
1
2
3
4
Add or Remove from Authorised Persons List
*
Add
Remove
Name
Name
*
First
Last
Relationship to Student
*
Mobile Number
*
Add or Remove from Authorised Persons List
*
Add
Remove
Name
Name
*
First
Last
Relationship to Student
*
Mobile Number
*
Add or Remove from Authorised Persons List
*
Add
Remove
Name
Name
*
First
Last
Relationship to Student
*
Mobile Number
*
Add or Remove from Authorised Persons List
*
Add
Remove
Name
Name
*
First
Last
Relationship to Student
*
Mobile Number
*
PARENT/GUARDIAN PERMISSION
*
PARENT/GUARDIAN PERMISSION
I give permission to Calvary Christian College to update the person/s authorised to collect the named child as listed on this form.
Parent/Guardian Name
Parent/Guardian Name
*
First
Last
Email
*
Mobile Number
*
Date
Date
*
/
DD
/
MM
YYYY
Draw your signature into the box below.
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.