Huron-Perth Catholic District School Board Self-Assessment Attestation for Parents/Caregivers
Notice of collection: Personal information on this form is collected under the authority of Section 32, Health Protection and Promotion Act RSO 1990 and in accordance with the Municipal Freedom of Information and Protection of Privacy Act, 1990 and the Personal Health Information Protection Act, 2004. It will be used as necessary by the Boards Human Resource Services and Ministries of the Government of Ontario. If you have any questions, please contact the principal of the school.
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Student First Name *
Student Last Name *
Student Grade *
It is a requirement that I screen my child for COVID-19 symptoms each school day to ensure they can attend school. I agree that I will monitor my child each day prior to sending them to school. I will use the Ontario COVID-19 Screening Tool for Students and Children in School and Child Care found at https://covid-19.ontario.ca/school-screening/ to screen my child. If the answer to any of the screening questions is yes, I agree that I will follow the directions given by the assessment tool. *
This agreement is to be completed by parents/caregivers of students (under the age of 18). We are relying on parents/caregivers for their partnership in our return to school.
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