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 NameLast 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*