Kelso Student Attestation Form

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We can save lives and stop COVID-19 if each of us does our part. The Kelso School District is following physical distancing directives and student health mandates from state and local governments as part of the collective effort to combat this disease. Protecting staff and student health, and the health of your families and friends, will take a commitment from each one of us.

Per the State of Washington Phased Reopening for School Districts, school districts require that students and staff receive a health screening before entering a school each day. Department of Health and Labor of Industries allows health screening to be performed at home (before work or the school day) as verified by a parent or guardian. A signed attestation is now required by the Washington State Department of Health and can be completed below. If you have any questions, please feel free to reach out to your students school office.

Student First Name (One student only) *

Student Last Name *

School *

Grade Level of student *

COVID-19 Symptoms

Under the direction of the Washington State Department of Health, the Kelso School District is requiring daily COVID-19 symptoms checks of your student prior to leaving to school each morning. This requirement is to ensure the safety and public health of our Kelso Schools and our greater Kelso community. I attest that I will be vigilant for assessing my student for COVID-19 symptoms. I will not send my student to school; (1) with symptoms, (2) if they have been identified as a close contact with a confirmed case of COVID-19, (3) if they have been COVID-19 tested in the last 10 days, or (4) if they have been told to self-monitor, isolate or quarantine

Parent Name--By adding my name below, I agree to the daily attestation requirements as set by the Washington State Department of Health. *

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