Science Safety Form for Mrs. Jesrani's Class
Dear Parent or Guardian,

Please start by carefully reading the following  Safety Contract with your child. 
Please complete this form together.  Students may not participate in science labs and activities until this form is complete.
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Student's First Name *
Student's Last Name *
Student's Birthday Month *
What period or block does your child have science? *
  Does your child wear contact lenses?   
 *
  Is your child color blind?  
 *
If your child has any allergies, please list.
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 This item is for the student to complete:

I have read the safety rules set forth in this  Safety Contract  . I agree to follow the policies to ensure not only my own safety but also the safety of others in the science classroom or laboratory. I also agree to follow the general rules of appropriate behavior for a classroom at all times to avoid accidents and to provide a safe learning environment for everyone. I understand that if I do not follow all the rules and safety precautions, I will not be allowed to participate in science activities and will be given alternate assignments. 

The student must type their first and last name to show that they have read and agree to the safety contract.
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  Dear Parent or Guardian: We feel that you should be informed of the school’s effort to create and maintain a safe science classroom/ laboratory environment. Please read the list of safety rules in the  Safety Contract  with your child . No student will be permitted to perform science activities unless this contract is signed by both the student and parent/guardian.  Your name typed on this form will serve as your signature.  Your signature  indicates that you have read this Science  Safety Contract , reviewed it with your child, and are aware of the measures taken to ensure the safety of your son/daughter in the science classroom.  

Parent or guardian, please type your first and last name below to show agreement to the above statement.  
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Best parent contact phone numbers.  *
Parent email.  *
Is there any other additional information you would like Mrs. Jesrani to know about your child? *
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