Short-term Parent Absence Form - Singapore American School

Required

High School

Please complete this form if both parents (or custodial parent/court-appointed legal guardian) are travelling out of Singapore at the same time. You must complete a separate form for each child in order to designate a temporary caretaker for your children.

The temporary caretaker must be at least 25-years-old.

If the temporary caretaker does not live with the child(ren), there must still be an adult (who is at least 25-years-old) living in the same residence as the child(ren).

Today's Date

Must contain a date in M/D/YYYY format

Student Namerequired

First Name

Last Name

Student Graderequired

Advisor's Namerequired

Name of Submitterrequired

Relationship to Student

Start Date of Parent Absence in Singaporerequired

Must contain a date in M/D/YYYY format

End Date of Parent Absence in Singaporerequired

Must contain a date in M/D/YYYY format

Parent Can Be Contacted Overseas at:

By submitting this form, I, as the parent/court-appointed legal guardian:required

designate the individual named below as the temporary caregiver of my child

Temporary Caregiver Information

Caregiver Namerequired

First Name

Last Name

Caregiver Email Addressrequired

Caregiver Mobile Numberrequired

Caregiver Work/Office Number

Caregiver Relationship to Student

Caregiver Residential Address

If address is different from home address on school record

Any Additional Information

By submitting this form, I, as the parent/court-appointed legal guardian:required

agree to allow trained medical professionals, like paramedics and hospital staff, to give my child any medical care, tests, or blood transfusions they think are necessary or in my child’s best interest
understand that no one has guaranteed or promised me specific results or outcomes from the above examinations or treatments on my child’s condition
acknowledge that the school will arrange for routine emergency medical/dental care and treatment necessary to preserve the health of my child

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Temporary Caregiver Information