Absence & Parent Declaration Form

Absence & Parent Declaration Form

*This form is to be used when students are returning to school after any absence.
Child's Name

First Name Last Name
Return Date to School

Day Month Year
Date
Reason for Absence

Illness Appointment Urgent Family Reason Other
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.
Signature

Clear
Should be Empty: