Second Year Return to Educational Facility Parental Declaration Form

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Second Year Return to Educational Facility Parental Declaration Form

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* Indicates required question

Email *

Your email

Child's Name: *

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Child's Year and Class:

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Parent's/Guardian's Name: *

Your answer

Parent's/ Guardian's Email Address *

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Parents Contact Number

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Name of the school:

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Declaration: I have no reason to believe that my child has an infectious disease and I have followed all medical and public health guidance with respect to exclusion of my child from educational facilities. (PLEASE SIGN BELOW)

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Date:

MM

/

DD

/

YYYY

Name *

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Email *

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Address *

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Phone number

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Comments

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