Pupil Leave Request: Extended Holiday I request that my child be withdrawn from classroom instruction for an extended holiday. Terms and Conditions I acknowledge that this leave has been explained to the school.I take full responsibility for my child’s safety and learning during this time.I understand that the school cannot be held responsible for missed instruction or any effect this may have on my child’s learning.I understand that teachers do not provide extra work or special programmes during this time.An acknowledgment of your leave will be emailed to you via the principal. Date 1st Child's Name Room Number 2nd Child's Name Room Number 3rd Child's Name Room Number Leave to start from Return to school on Reason for leave Email Phone I have read and understand the terms and conditions please tick the box Send