Student Mask Parent Permission
By recommendation of the Pennsylvania Department of Health, all people are asked to wear a face covering, while in school. CCCS desires to keep students, faculty, staff, visitors to the school safe and healthy.

Therefore, if your child has a medical/mental health condition in which wearing a face covering would not keep them safe or healthy, please let us know by completing. :) Call Mrs. Cannon if you have questions.

This order does specifically require schools to permit exemptions for medical reasons.
According to the order, "A school Entity must provide reasonable accommodations for individuals who state they have a medical condition, mental health condition, or disability that makes it unreasonable for the person to maintain a face covers."  


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Please answer who is completing this form, on behalf of the student. *
Required
Student Name *
Please list the parent name, who is completing the form. *
Student Grade *
My child CANNOT wear a mask due to a medical condition, mental health condition (i.e. stress, anxiety) or a disability. *
My child is UNABLE to take off and put on their mask without assistance. *
My child has communication needs (hearing disability/educational needs) and is unable to wear a mask. *
Our family, desiring a Christian education, also would like our child to be exempt due to our religious beliefs from my child receiving the COVID vaccination and wearing a face covering while in school. *
Please type your name below, which will serve as your signature for this form. *
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