2022 California Healthy Youth Act Exemption Form
The California Healthy Youth Act requires all public schools to provide ​comprehensive sexual health education and HIV prevention education to students at least once in middle school and once in high school. In the 2019-20 school year, Santa Rosa Academy will provide this instruction to students in grades 8 and 9. The California Healthy Youth Act: SEC. 15. Section 51939 includes a provision for parents to exempt their students from this instruction:

(a) A pupil may not attend any class in comprehensive sexual health education or HIV prevention education, or participate in any anonymous, voluntary, and confidential test, questionnaire, or survey on pupil health behaviors and risks, if the school has received a written request from the pupil’s parent or guardian excusing the pupil from participation.

 (b) A pupil may not be subject to disciplinary action, academic penalty, or other sanction if the pupil’s parent or guardian declines to permit the pupil to receive comprehensive sexual health education or HIV prevention education or to participate in anonymous, voluntary, and confidential tests, questionnaires, or surveys on pupil health behaviors and risks.

(c) While comprehensive sexual health education, HIV prevention education, or anonymous, voluntary, and confidential test, questionnaire, or survey on pupil health behaviors and risks is being administered, an alternative educational activity shall be made available to pupils whose parents or guardians have requested that they not receive the instruction or participate in the test, questionnaire, or Survey.
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Email *
Parent's Full Name *
Parent's Email *
Student's Full Name *
Student's Email *
Grade *
Physical Education Teacher's Name: *
I wish for my student to Opt-Out from the Comprehensive Sexual Health Education program, HIV Prevention Education program for the 2021/2022 school year, and any associated anonymous, voluntary, and confidential test, questionnaire, or survey on pupil health behaviors and risks.   *
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