2021-2022 Parent Responsibility COVID Questionnaire
Please be sure to complete 1 FORM PER CHILD. By completing this form, I will only send my child to school if:

- They are feeling healthy and well, do not have a temperature of 100F or higher and are
not exhibiting any of the symptoms as described by the CDC.
(https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html)

- Within the last 10 days, they have not been in close contact with anyone who has been diagnosed with COVID-19. This includes all members of the child's household. Vaccinated individuals may remain in school provided that they test negative on day 5 and continue to have no symptoms.

- Within the last 10 days, they have not tested positive for COVID-19 or been diagnosed as COVID-19 positive by a healthcare provider and have no outstanding COVID-19 tests.

- They have traveled following the guidance set forth by the SCDOH.
(https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html)

If these guidelines change or are updated by NYS or the federal government, it is your responsibility to adhere to the most recent active regulations.  

If at any point, your child does not meet the criteria for any of the above statements, please DO NOT SEND YOUR CHILD TO SCHOOL and contact the School District immediately.

By completing this form you attest that you will adhere to the guidelines for the 2021-2022 school year.

Para realizar esta encuesta en español, visite este enlace: https://forms.gle/H8SUYfwxv4EqpdDC6

Due: August 30, 2021
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Student First Name *
Student Last Name *
School *
Grade *
By clicking this button, I attest to the above information and only send my child to school if they meet the criteria listed above. *
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