Face Shield Request Form

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Please fill this form out if you are requesting to wear a face shield instead of a face mask. Responses will be reviewed and you will be alerted when requests are approved or denied within five business days.

Email *

Students are permitted to wear both a mask and a face shield if desired without completing this form. Face shields DO NOT mitigate the risk of spreading the virus as well as face masks worn properly do. But to request wearing a face shield INSTEAD of a mask, the family is agreeing to the following: The family will provide their own face shield that completely covers the child's nose, mouth and comes down below the chin. The family agrees to keeping the face shield cleaned daily with disinfectant wipes or spray. The student agrees to wear the face shield at all times the masks are expected to be worn. *

I agree

I disagree

Parent Name *

Student Name *

Grade *

Please explain the reason for your request. *

A copy of your responses will be emailed to the address you provided.

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