PUSD Health and Safety Agreement

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

I have read, understood and agree to the terms and conditions outlined in the Poway Unified School District Parent/Guardian Health and Safety Agreement for In-Person Instruction for the 20-21 School Year.

Please see the complete Health and Safety Agreement PDF linked in the Weekly Wildcat.

I understand that by signing this Google Form, I will be signing the Health and Safety Agreement in lieu of signing the physical form.

Email *

Student Name (First and Last) *

Student Name #1 (First and Last)

Teacher #1

Student Name #2 (First and Last)

Teacher #2

Student Name #3 (First and Last)

Teacher #3

Student Name #4 (First and Last)

Teacher #4

Student Name #5(First and Last)

Teacher #5

Parent/Guardian Name (First and Last) *

Parent/Guardian Signature and Date *

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Poway Unified School District. Report Abuse

Forms