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Leckaun N.S.
Please complete this form before your child returns to school after any absence.
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Email
*
Your email
Child's Name:
*
Your answer
Reason for absence
*
Your answer
Dates of absence from
*
MM
/
DD
/
YYYY
to
*
MM
/
DD
/
YYYY
Declaration: I have no reason to believe that my child has an infectious disease and that I have followed all medical and public health guidance with respect to the exclusion of my child from educational facilities.
*
Please click to confirm this declaration
Required
Date of Return to School:
*
MM
/
DD
/
YYYY
Name of Parent / Guardian
*
Your answer
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