Welcome to our parental consent and student welfare document. This document is important to ensure that we have all the necessary permissions and information to be able to care for your child while they are experiencing their language journey. Contact Details Parent / Guardian Name Contact Email Home Phone Number Mobile Phone Number (Parents) Student Details Student Name Date of Birth Current Age of Child Mobile Phone Number (Student) Arrival Departure Parental ConsentI hereby give my consent to my child (named above) to Travel to the island of Malta on his or her own and participate in a language journey with Maltalingua School of English: Yes No I agree to allow my child to join in all age appropriate activities and excursions organised by Maltalingua or third parties contracted by Maltalingua. Yes No I grant my permission to use the photographs taken by Maltalingua at school or on school activities for use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Yes No Participate in motor powered activities such as water skiing, jet skiing, banana boat rides and crazy sofa rides. I agree that Maltalingua may not be held liable for accident or injury as a result of my child partaking in such activities: Yes NoMedical Conditions Does your child suffer from any conditions requiring medical treatment? None Asthma Diabetes Psychological Disorders Sensitivity to Sun Other… Enter other… Does your child suffer from any allergies or intolerances? None Pollen Medicines Food ? Drinks Other… Enter other… Is there any food which your child will not eat (please include medical or religious reasons) or is your child vegetarian? (if yes, please give details) Yes No Details Is your child taking medication of any kind? (if yes, please give details) Yes No What medication is your child taking? How often should this be taken? Does your child need assistance taking the medication? Does your child carry a medical emergency kit with medication in it? (if yes, please give details) Has your child had an operation within the last 12 months? (if yes, please give details) Yes No Details Safety Can your child swim without swimming aids? Yes No I hereby give my consent to Maltalingua to take my child (named above) to Mater Dei Hospital in the event of any acute medical and/or surgical emergency. Yes NoFor Responsible Minors Aged 16 and 17 OnlyParents consent to give their 16 or 17-year-olds greater freedom and to choose to opt-out of specific school excursions and activities. It is important to note that minors will be unaccompanied during these times. Students must still inform Maltalingua staff of their plans and return at the agreed times.If your child is aged between 8 - 15 they are not allowed to opt-out of our activities or change their allocated curfew times, so please select no. Opt out of specific optional school activities - For minors Aged 16 and 17 only Yes No Opt out of recommended curfew times - For minors Aged 16 and 17 only Yes NoI confirm that the details provided are correct. I understand that Maltalingua reserves the right to send a student home should a situation arise during their stay as a result of parents/guardians having failed to fully and accurately answer the above questions. Name Date Signature Thank you for the information provided. It will help us with the welfare of your child. Leave this field blank