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ENROLMENT RECORD: ADDENDUM TO THE ENROLMENT FORM
AUTHORISED NOMINEES FOR TRANSPORTATION BY A THIRD-PARTY TRANSPORT SERVICE - This form is provided in accordance with Regulation 161(1) and Regulation 102B of the Education and Care Services National Regulations 2012, and Section 165(4)(a) of the Education and Care Services National Law (WA) Act 2012.
Location
(Required)
Busselton
Margaret River
Child(ren)'s Full Name(s):
(Required)
Child(ren)'s DOB(s):
(Required)
Parent/Guardian Authorisation and Acknowledgment
(Required)
I hereby appoint KaGo Transport Services Pty Ltd and its approved Authorised Nominees for the transportation of my child/ren.
I understand and acknowledge that by doing so:
• I authorise the Education and Care Service where my child/ren are enrolled to release my child/ren into the care of KaGo Transport Services Pty Ltd and its approved Authorised Nominees for the purposes of transportation.
• I consent to the release and collection of my child/ren as detailed and authorised in the Transport Authority Form.
• I understand that the Education and Care Service is not the transportation provider and has engaged a third-party transport service to facilitate transportation arrangements.
• I acknowledge that KaGo Transport Services Pty Ltd and its approved Authorised Nominees are acting as independent authorised nominees for the purposes of transportation, and that responsibility for transportation lies with the third-party provider and not the Education and Care Service.
I further agree and acknowledge that:
• I release the Education and Care Service, its employees, and agents from any and all claims or liability arising from or related to transportation services provided by KaGo Transport Services Pty Ltd and its approved Authorised Nominees.
Sign In Consent
(Required)
I authorise an approved Authorised Nominee of KaGo Transport Services Pty Ltd to sign my child/ren into the Service.
Sign Out Consent
(Required)
I authorise an approved Authorised Nominee of KaGo Transport Services Pty Ltd to sign my child/ren into the Service.
Full Name:
(Required)
Parent / Guardian Signature
(Required)
Date
(Required)
DD slash MM slash YYYY
