| A | B | C | D | E | F | |
|---|---|---|---|---|---|---|
1 | ||||||
2 | ||||||
3 | Family name/Surname in BLOCK CAPITALS | |||||
4 | Individuals authorised to collect children on behalf of parents/guardians | |||||
5 | ||||||
6 | Names: | Phone # | ID type *copy attached | |||
7 | (eg drivers license, work ID, passport etc) | |||||
8 | 1 | |||||
9 | 2 | |||||
10 | 3 | |||||
11 | 4 | |||||
12 | 5 | |||||
13 | ||||||
14 | Authorised to collect the following children: | |||||
15 | 1 | |||||
16 | 2 | |||||
17 | 3 | |||||
18 | 4 | |||||
19 | 5 | |||||
20 | ||||||
21 | Signature of parent/guardian: | Date: | ||||
22 | ||||||
23 | Parents phone #s: | |||||
24 | ||||||
25 | Please attach photo ID eg. drivers license, work ID, NSSF card etc as proof of identity for all authorized individuals | |||||
26 | ||||||
27 | NB Always inform reception if there is a change to this information | |||||
28 | Senior School Reception: | 0756-744-834 | ||||
29 | Junior School Reception: | 0752-403-961 | ||||