Disaster Management Act, 2002 (Act No. 57 of 2002)

Notices

Directions regarding the phased return of children to Early Childhood Development Programmes and Partial Care Facilities

Annexures

Annexure B : Form 2 : Certificate for Child to travel to another Province or Metropolitan Area or District Area
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ANNEXURE B

FORM 2

(FORM 3A to the Regulations)

CERTIFICATE FOR CHILD TO TRAVEL TO ANOTHER PROVINCE OR METROPOLITAN AREA OR DISTRICT AREA

(Regulation 34(5))

To be completed by the head or manager or a person authorized by the head or manager

 

I, ________________________________________________ (Name and surname)

 

Details of head/manager or delegated person and an early childhood development programme or partial care facility

Full names

Surname

Identity number

Mobile number

Details of an early childhood development programme or partial care facility

Name

Full physical address

Province it is situated

 

Metropolitan area/district

Telephone

Email address (if available)

 

In my capacity as head/manager or delegated person of the above early childhood development programme or partial care facility, I hereby declare that the undermentioned child is attending this early childhood development programme or partial care facility, and need to travel between different provinces/ metropolitan areas/districts to attend this programme.

 

Details of CHILD attending

Full names:

Surname:

Date of birth

Full address of place of residence of child:

Province of residence

Metropolitan area/district

Details parent of legal guardian

Name and surname

Mobile number

Telephone number

 

Email address (if available)

 

 

Signed at ___________ this _____________ day of____________________2020

 

_____________________________


Official stamp

in the case where there is no official stamp, another person needs to co-sign in this space

Principal/manager or or delegated person issuing