Job Shadowing - Parent Permission Form

As parent/legal guardian of Student First Name* Student Last Name* , I give permission for my child to participate in an on-site job shadowing experience at Business Name* on Date* from Time* to Time* .

I agree to the following:
o Be responsible for student’s behavior at the shadowing site and school.
o Provide transportation for child.
o Provide health insurance for child.
o Give permission for child to receive emergency medical treatment in case of injury or
illness.
o Release the business from responsibility should an accident occur.
o Give permission to the school district to collect date on child’s experience for use in
scholarly reporting.
o Give permission to the school district for all still photographs, videotapes, or audio
recordings taken of child to be used in whole or part.
o Understand the school personnel may not be present when student is at the site.

Parent Name *

First Name Last Name

Parent Phone Number *

Please enter a valid phone number.

Alternate Phone Number *

Please enter a valid phone number.

I agree to the following: *

I will be responsible for student’s behavior at the shadowing site and school. I will provide transportation for my student. I give permission for my student to receive emergency medical treatment in case of injury or illness. I release the business from responsibility should an accident occur. I give permission to the school district to use all still photographs, videotapes, or audio recordings taken of child to be used in whole or part. I understand that school personnel will not be present when student is at the job site.

Signature *

Clear