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Parental onsent Form (M1-M4) - International School Moshi

Parental onsent Form (M1-M4) - International School Moshi

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<strong>Parental</strong> C<strong>onsent</strong> <strong>Form</strong> for <strong>M1</strong>, M2, M3 and <strong>M4</strong> Boarding Students<strong>School</strong> Year 2013/2014The C<strong>onsent</strong> form is to help boarding parents make informed decisions, and should be updated each year. All privileges are at thediscretion of the boarding staff.Please read the Boarding Handbook before completing this form.STUDENT’S NAME: CLASS;Please place a tick in the box of your choice:1 The student may withdraw up to TSh____________ per week from the school bank.YES NOWe recommend pocket money of 5,000/= to 12,000/= per week. Funds for OP trips,9 The student may have unsupervised access to the Internetapproximately $30 to $60 per trip, may be kept in a separate account if requiredunder conditions specified by the school.YES NO 10 The student may take part in trips arranged by people or2 The student may use a taxi to and from (i) <strong>Moshi</strong> townorganisations outside the school(ii) Arusha 11 Declaration:(iii) Airport I authorise the boarding staff to sign permission forms for school organised(iv) Anywheretrips as follows3 The student may use public buses to & from (i) <strong>Moshi</strong> town A Educational trips in Tanzania(ii) Arusha B Educational trips beyond Tanzania(iii) Airport C Other school trips (camping, mountain, sports) in Tanzania(iv) AnywhereD Other school trips (camping, mountain, sports) beyondTanzania4 The school should provide transport to and from the airport at the costspecified in the Boarding Handbook.WEEKEND AND HOLIDAY INVITATIONS:5 The student may accept lifts from members of the teaching staff 12 When students accept weekend or holiday invitations with other6 The student may accept lifts from the parents or employed drivers of otherstudents at the discretion of the boarding staff. (i) In <strong>Moshi</strong> area(ii) To & from Arushafamilies, we cannot guarantee the degree of supervision they mayreceive. You may therefore wish to communicate directly withparents they wish to sign out to, and then confirm with us that it isa satisfactory arrangement.PLEASE CHECK EITHER A OR B NOT BOTH7 The student may accept lifts from any other driver at the discretion of theschool’s administration.MY DAUGHTER/SON CAN DRIVE WITH THE STUDENT DRIVER NAMED BELOW IFPERMISSION IS ALSO GIVEN BY THEIR BOARDING PARENT ON EACHOCCASION:8 The student may visit <strong>Moshi</strong> town unsupervised as part of a boarding trip,normally taking place on Friday afternoon or Saturday morning.(iii) Anywhere A The student may, without my specific confirmation, acceptinvitations to any families of other students(i) in <strong>Moshi</strong>(ii) in Arusha(iii) anywhereBOR………………………………………………………………………..The student may only accept invitations if I have confirmedthe arrangement personally:I would like to confirm in advance that the student may acceptinvitations to the families listed here:YESNOYES NO


13. HOLIDAY ACCOMMODATION BEFORE AND AFTER TERM TIMEThe school cannot offer boarding facilities to students before the start or after the end of term.Please state what arrangements you wish us to make in the event that the student arrives before the start or departs after the end of term or during half term breaks14. FOR ARUSHA RESIDENTS ONLY—CIRCLE ONEMy child will return home to Arusha every weekend to stay at home from Friday to Sunday. I guarantee to advise the boarding parent in advance of any weekend when my child plans tostay in school or travel elsewhere. ORMy child will stay in school every weekend unless specifically given permission to travel elsewhere.I have completed this parental c<strong>onsent</strong> form after reading and understanding the Boarding Handbook. Any changes to the information on this c<strong>onsent</strong> form may only be made bythe parent or guardian whose signature appears on this form(Signature of parent/ guardian) (Date)CONTACT INFORMATION (Parent/guardian)PLEASE GIVE YOUR CURRENT EMAILADDRESS AS REGULAR COMMUNICATIONFROM SCHOOL WILL NORMALLY BE BYEMAILNAME:ADDRESS:LOCAL GUARDIANNAME:ADDRESS:EMERGENCY CONTACTWhere possible, please give us the name andaddress of a family in the <strong>Moshi</strong> or Arusha areawho can be contacted in the event of anemergency.NAME:ADDRESS:LANDLINE:MOBILE:LANDLINE:MOBILE:LANDLINE:MOBILE:FAX:Email:FAX:Email:FAX:Email:

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