Pacific School Volunteer Agreements for 2023-24
Please complete this form if you are going to volunteer in any capacity around students during the 2023-24 school year. This includes driving on field trips, volunteering in the classroom, etc.
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Email *
Your name *
Staff member(s) you expect to work with most closely while volunteering (or DRSC): *
Type of volunteer work you expect to be doing: *
Infectious Disease Safety
Do you agree to screen yourself for the following symptoms each day before you come Pacific School: fever/chills, cough, shortness of breath/difficulty breathing, fatigue, muscle/body aches, headache, new loss of taste/smell, sore throat, congestion/runny nose, nausea/vomiting, diarrhea. *
Do you agree to stay home and not volunteer at Pacific School if you have new or unexplained fever/chills, cough, shortness of breath/difficulty breathing, fatigue, muscle/body aches, headache, new loss of taste/smell, sore throat, congestion/runny nose, nausea/vomiting, diarrhea? *
Do you agree to stay home and not volunteer at Pacific School if you have symptoms of or test positive for COVID-19, influenza (the flu), other easily spread diseases (such as pink eye/conjunctivitis) or have reason to suspect that you are likely to be infected or infectious? *
Do you agree to wash your hands frequently whenever you are at Pacific School, including at the following times: upon arrival, before and after eating, after using the bathroom? *
To the extent that it is appropriate within your role as a volunteer, do you agree to support students in washing their hands frequently whenever they are at school, including at the following times: upon arrival, before and after eating, after using the bathroom? *
As of August, 2023, masks are optional for all school community members in all settings. Pacific School provides masks to students, staff, or volunteers who want them. Do you agree to be equally supportive of community members who choose to wear or not wear masks while at school? *
Student and Family Privacy

PLEASE READ ALL OF THE FOLLOWING INFORMATION CAREFULLY. If you have any questions about this information, please discuss it with Superintendent/Principal Eric Gross.

The following types of information about students are CONFIDENTIAL:

- Academic strengths, weaknesses, skills, performance on tests, etc.
- Special education status, resources received or declined, etc.
- Discipline issues or disciplinary actions taken by staff
- Medical information, diagnoses, etc.
- Any details about a student’s family life or personal situation. (Parents and students need to make their own decisions about what to reveal publicly.)
- Immigration status
- Any information that might be embarrassing or sensitive

Students at Pacific Elementary School have the right to expect that all volunteers will keep information about them confidential. California law prohibits school volunteers from giving out any personal information concerning any student who is not their own child to any person other than a teacher or administrator at the school. California law also prohibits sharing information about a student's circumstances without using their name.

Additionally, the U.S. Congress has addressed the privacy-related concerns of educators, parents, and students by enacting the “Family Educational Rights and Privacy Act (knows more commonly as “FERPA” or the “Buckley Agreement”). FERPA allows the government to take funds away from any school which spreads a student’s educational information without their parents’ consent.

Each student with whom you work has the right to expect that nothing that happens to or about him or her will be repeated to anyone other than authorized school employees. You are authorized to share confidential student information with the student's teacher and/or the principal only. Even when discussing a student with those who are directly involved in a student’s education, such as a teacher or principal, you may not share otherwise confidential information with them unless it is relevant to the student’s educational growth, safety, or well being.

You may not share information about a student even with others who are genuinely interested in the student’s welfare, such as club leaders, relatives, family friends, other school personnel, or clergy. Thus, you must refer all questions about confidential student information to the student’s teacher or the principal. You may, however, share relevant confidential information with emergency responders if it is necessary for the student's health during a medical emergency. You may also share confidential information with child protective services if you are filing an official report of potential child abuse.

Parents, friends, or community members may in good faith ask you questions about a student’s problems or progress. Again, you must refer all such questions to the authorized school employees. You may not share information about a student even with members of your own family or the student’s family.

Remember that violating a student’s confidentiality is unethical, against the law, puts the school at risk, and is hurtful to families and our community.
I understand what types of information is considered confidential (review the list of bullets above). *
I agree to discuss confidential information only with the student's teacher or with the principal. *
If I need to discuss confidential information with the student's teacher or the principal, I agree to do so in a private setting and quiet voice, so that others will not hear me. *
Pacific School is a small community in which everyone knows everyone else. I understand that discussing confidential information without names is still illegal and inappropriate, and I will not do it. *
I know that sometimes well-meaning people, including the student's parents, may ask me for confidential information. I will refer all such requests for information to appropriate school employees. *
I agree not to share or post photographs of students at school or participating in school activities without permission of the district or the parents of all students photographed. *
I understand that failing to handle confidential information appropriately puts Pacific School at risk for (check all that apply - HINT: the right answer is all of them): *
Required
By typing your name below, you are electronically signing that, as a volunteer for the Pacific Elementary School District, you agree to follow all of the student privacy and confidentiality rules described above. *
A copy of your responses will be emailed to the address you provided.
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