COVID-19 Test Kit Pick-Up Consent Form
Parents and guardians: Please complete the information below if you are giving consent for someone else to pick up your child(ren)'s test kits on your behalf. He/she will need to provide photo ID. Thank you.
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Email *
Parent/Guardian Last Name *
Parent/Guardian First Name *
List  School-age Child(ren)'s Names/Schools/Grades *
First, Last Name of Person Picking Up Test *
By typing my name below, I acknowledge that I given the individual named above permission to pick up my COVID-19 test kits on my behalf.   *
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