St. Luke's Academy

Inspiring Excellence

St. Luke's Academy

Consent Form for Collection of students from St. Luke's Academy

TO BE COMPLETED BY PARENTS/GUARDIAN:

The named adults below have my authorisation to collect my child from St. Luke’s Academy in my absence. I request (fill in below) security decals which I agree to return once my child/ward in no longer enrolled at St. Luke’s Academy. Two (2) stickers are complimentary $5 for each addtional decal sticker.

Student Collection Form
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Name of Student
My Chosen password for person not listed above to collect my child/ward is:

It is parents/guardians reponsibility to inform St. Luke's Academy to any change that may occur to the authoised person collection and/or to any change required to the password. I agree to update St. Luke's Academy Administrators with any changes.

Mother/Guardian Name
Father/Guardian Name

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