AUTHORIZATION OF LEGAL REPRESENTATIVE
Please note that either Mr. Andries Erwee or Ms. Ronell Erwee from Temba College will accompany Ananja and not both of them.

I the undersigned (Name of Parent.

residing
being the Mother/father or gaurdian.

Authorize my son /daugther

Named

born at............................................................................. on…
to travel to the United Kingdom from 20 June 2010 to 24 June 2010 on a achool Tour. They will stay in Thameslink Youth Hostel in Londen. Tel nr. 0845 3719756, I hereby request the UK Government to issue the visa.

I hereby appoint Mr. Andries J Erwee or MS Ronell Erwee to act in Loco Parentis from 20 Jun to 24 June 2010.   In this capacity they will be responsible for the welfare of the above mentioned child.

This includes:
* The granting of permission which may be required by a hospital or medical practitioner for any medical attention that may be deemed necessary.
* The signing of any document that he deemed necessary for the welfare of the above mentioned child during the tour.
* Lawful action that may be necessary for the order and discipline on the tour.

The appointment takes place under the condition, that Mr. Erwee or Miss Erwee will inform me as soon as possible of any use of this appointment.   I further more except that neither Mr. Erwee Miss Erwee will be financially responsible for cost arising from above appointment.

I hereby declare that I have full authority over this child and that I am the legal guardian of this child.  I further declare that the above information is correct.

Date.................................

Signature of the parent who completed the form..................................

Signature of other parent.....................................
I hereby declare that this form is signed by the legal parent or guardian of the above mentioned child.
Com of oath (He or she must also stamp the form.)