KPDSB Mask/Face Covering Accommodation and Exemption Request Form - 2021-2022 School Year
UPDATE - EFFECTIVE MONDAY, JANUARY 17, 2022, MASKING WILL BE MANDATORY FOR ALL KINDERGARTEN STUDENTS IN KPDSB SCHOOLS.

As per the Ontario Government's COVID-19: Health, Safety and Operational Guidance for Schools (2021-2022), masks/face coverings are required for all students in grades 1-12 to reduce the spread of COVID-19.  We recognize there are specific instances when wearing a mask/cloth face covering may not be feasible. Students may be granted an accommodation/exemption from wearing a non-medical mask/face covering for reasons related to a medical condition, mental health, sensory, breathing difficulties or other reasons deemed reasonable by the school Principal.

This form is to be used to start a meaningful conversation between the school principal/vice-principal and parents/guardians in order to determine the needs of the student and accommodate these needs where necessary.

When requests for accommodation are made, Principals/Vice-Principals will follow Board guidance on exemptions as outlined below:

- Masks/face coverings may not be tolerated by everyone based on underlying health issues. Consideration should be given to mitigating physical or psychological challenges that may inadvertently be caused by wearing a mask/face covering (e.g. interfering with the ability to see or speak clearly). In the latter case, to improve visibility for example, for lip-reading the use of clear masks and face shields may work.

- Masks/face coverings may not be required for students who cannot wear or are unable to apply or remove a mask/face covering without assistance, including those who are accommodated under the Accessibility for Ontarians with Disabilities Act (AODA) or who have protections under the Ontario Human Rights Code, R.S.O. 1990, c.H.19, as amended.

- As part of the Mask/Face Covering Accommodation/Exemption Request process, appropriate medical documentation/relevant information pertaining to the health issue may be requested for students who have health issues/disabilities that prevent them from wearing a mask/face covering. The medical documentation, when requested, will confirm there is a disability-related need (not provide a diagnosis).

Parents/guardians requesting an accommodation/exemption for their child are to complete the form below based on the reasons outlined.  A copy of your responses will be shared with the principal or vice-principal at your child's school.   Parents/Guardians will then have an opportunity to meet with the principal/vice principal to discuss the situation and basis for the accommodation/exemption request.

If you have any questions or concerns, please contact your school Principal/Vice-Principal.  For further information, parents/guardians may wish to review the Mask/Face Coverings: Guidelines for Students located on our website under the 2021-2022 Information and Updates.

PLEASE FILL OUT ONE FORM PER CHILD.
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Student First Name: *
Student Last Name: *
First and last name of parent/guardian filling out this form: *
Which school is your child registered at for the 2021-2022 school year? *
Which grade is your child in for the 2021-2022 school year? *
Most up-to-date phone number for your family: *
Most up-to-date email address for your family: *
Please provide the reasons you are requesting an exemption below. *
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