Boarding House Routines (Continued) - Ipswich Grammar School

Ipswich Grammar School Boarding House
Application For Leave
This application contains the terms on which the student’s leave is approved by the School. If at any time after the School approves this leave
application, the type or duration of the leave changes in any manner, the Parent or Guardian must immediately notify the School of the changes.
The Parent or Guardian acknowledges that they will be liable for the safety of the Student for the duration of the leave period and
the School is absolved from all responsibility in this regard. In particular, the Parent or Guardian agrees that the School will have no
responsibility whatsoever for the safety of the Student when travelling to and from the School premises. Risks associated with the Student’s
method of travel to and from the School premises are to be accepted by the Parent or Guardian and the Student. The Parent or Guardian
agrees that the School is under no obligation to provide supervision to the Student during travel to and from the School premises.
Requests for leave from class during Term must have the permission of the Year Coordinator. Parents are reminded that students have the
obligation to attend all classes, activities, games and training sessions to which they are committed.
* ALL FIELDS MARKED WITH AN ASTERISK MUST BE FILLED IN:
* Student’s Name:
Departure Date & Time: * Date: * Time:
dd / mm / yy
Return Date & Time: * Date: * Time:
dd / mm / yy
* Type of Leave: Day Overnight End of Term (Please Tick)
Name/Address/Contact Details of Student Destination: * Name:
* Address:
* Telephone:
* Method of Travel/Additional Information:
I, (name of Parent or Guardian to be inserted), make application for the
above leave. I accept that I will be liable for the safety and care for my son from the departure time and date shown on this form and
I release the School from all liability for my son’s safety for the period of leave.
* Signature/Password
of Parent/Guardian: * Date:
* Parent/Guardian
Emergency Contact
Number for Leave period:
* Student Mobile:
dd / mm / yy
Leave application should be made by 12 midday on the Thursday morning prior to the leave request date.
End of Term notification should be made 2 weeks prior to END OF TERM.
RETURN THE FORM EITHER BY: Fax: (07) 3280 1311
Email to: bhouse@ipswichgrammar.com
Mail: Boarding Office, Ipswich Grammar School, Locked Bag 6000, North Ipswich Qld 4305