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Exeat and Leave Weekend Request Forms

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Pupil's Name
House:
My son/daughter will be staying with the following person(s)
Name(s)
Address
Telephone:
Please describe how he/she will be travelling from the School to the above address
Please describe how he/she will be travelling back to the School from the above address

Declaration

I accept full responsibility for my son's/daughter's health and safety from the time that he/she leaves Charterhouse until his/her return. I accept too that the school rules apply outside the School as well as within it.

I accept responsibility: Yes     No
Parent/Guardian details
Name:
Address:
Telephone:
Email:
Password text

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