Full Reentry Student- Family Agreement Form

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Bernalillo Elementary School Spring 2021

Date *

YYYY

Student Name *

Student ID *

Parent/Guardian Name *

Parent/Guardian Phone Number *

Parent/Guardian email *

As the parent/guardian of this student, I understand and agree to support the school in providing the safest full re-entry environment possible. With this, I agree to the statements below. I also understand that if my student does not comply with these expectations, I will be expected to pick up my student immediately. If this becomes a reoccurring situation, I understand my student will be required to return to the 100% virtual platform.

Conditions to qualify for full in-person, learning (checkmark the box next to each statement): *

I agree to send my student without a fever.

I agree to come pick up my student if my student comes down with a fever or COVID like symptoms

I agree that if I am unable to pick up my student immediately, I will give permission for someone to pick up my student.

I agree to send my student with a mask every day

I agree to send my student with their chrome book and charger for in-person learning every day.

I agree to pick up my student if they refuse to wear a mask or refuse to follow any COVID protocols (i.e. keeping greatest distance possible, staying to the right in the hallways, wearing a mask at all times, following directional signs, etc. This is not an all-inclusive list).

I have read and agree to support the behavioral expectations and safety procedures put into place by the school or my student will be returned to the 100% virtual platform only.

I agree that my student will stay fully virtual or fully in person, all 5 days of the week. If a family’s choice does change in the future, we do require communication with administration, before the change of learning environment occurs.

Required

By submitting this form you and your student agree to all the expectations and statements listed above.

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