WNYMCS COVID-19 Testing Permission Slip

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• I have signed this form freely and voluntarily, and Iam legally authorized to make decisions for the child named below.
• I consent for my child to be tested for the Covid-19 infection.
• I understand that my child may be tested multiple times from January 2021 through the end of June 2021 when the school is in a Yellow, Orange or Red Zone.
• I understand that my consent form will be valid from January 2021 through the end of June 2021 , unless I notify my child's school in writing that I revoke my consent.
• I understand that if I revoke my consent or refuse to sign, my child will be required to continue their education via remote learning.

Email *

Testing agreement: *

I DECLINE testing and understand my child must remain a virtual student until the end of the current 5 week marking period at the end of January. Virtual education will continue for 5 week increments until I consent or the school year ends.

I ACCEPT testing for the child(ren) I will list.

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