COVID-19 Family Health Agreement
This agreement is to be completed by parents/guardians of students (under the age of 18). We are relying on parents/guardians for their partnership in our return to school. Please read all details, check the "I agree" boxes and complete before September 24, 2021. Please note, only one form needs to be completed per family/household at each school.
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SCHOOL NAME *
FAMILY LAST NAME *
STUDENT(S) FIRST NAME(S) *
DAILY SCREENING: I agree that I will screen my child(ren) for COVID-19 symptoms each school day to ensure they can attend school using the ONTARIO SCREEN TOOL (https://covid-19.ontario.ca/school-screening/) and follow the directions on the tool. If my child does not pass the screening tool I will not send them to school. I will confirm this this result using the school’s QR Code Form each day prior to sending my child to school. *
MASKS: I agree that as per the Ministry of Education Operational Guidance for Schools and HPPH Recommendations that all students between the grades of 1-12 are to wear a non-medical mask or cloth face covering while indoors during the school day and students in Kindergarten are strongly recommended (but not required) to wear masks. *
FOLLOWING PUBLIC HEALTH GUIDANCE: I agree to follow guidance from HPPH should my child test positive for COVID-19 or be identified as a high-risk close contact to a confirmed case (including self-isolation). I am aware that this guidance may be impacted by vaccination status (e.g. vaccinated students may receive different direction than unvaccinated students). *
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