THIS INDEMNITY made the day ___________ of­­­­­­ _____________ 20___ BETWEEN

____________________________(lawful father and mother or guardian of ) of

________________________________(hereinafter called ‘the parents’) of the One Part AND

_________________________________for and on behalf of the Board of Management of St Joseph’s GNS situated at Convent Hill, Skibbereen,  in the County Cork of (hereinafter called ‘the Board’) of the Other Part.


1. The parents are respectively the lawful father and mother or guardian of _________________, a pupil of St Joseph’s GNS Skibbereen.

2. The pupil suffers on an ongoing basis from the condition known as _____________________.

3. The pupil while attending St Joseph’s GNS requires the administration of medication.

4. The parents have agreed that the said medication may, be administered by the said pupil’s classroom teacher and/or such other designated member of staff of St Joseph’s GNS, as per the Administration of Medication/Monitor Medical Condition Form attached hereto.

NOW IT IS HEREBY AGREED by and between the parties hereto as follows:

  1. In consideration of the Board entering into the within Agreement, the parents, as the lawful father and mother or guardian, respectively of the said pupil HEREBY AGREE to indemnify and keep indemnified the board, its servants and agents including without prejudice to the generality of the foregoing the said pupil’s class teacher or other designated member of staff and/or the Principal of the said school from and against all claims, both present and future, arising from the administration or failure to administer the said medicines.

IN WITNESS whereof the parties hereto have hereunto set their hands and affixed their seals the day and year first herein WRITTEN.

SIGNED by the parents in the presence of:

SIGNED AND SEALED by the said in the presence of: