Parental Consent for Sunscreen Assistance
Provide written consent for a volunteer employee to apply sunscreen to your child if they can’t self-apply.
Student Name
*
First Name
Last Name
School
*
Please Select
Antimony Elementary
Boulder Elementary
Bryce Valley Elementary
Bryce Valley High
Escalante Elementary
Escalante High
Panguitch Elementary
Panguitch Middle
Panguitch High
Garfield Online
Grade
*
My student is unable to self-apply sunscreen. I give written consent for a volunteer school employee to apply sunscreen to my student. I understand that under Utah law, neither the volunteer school employee nor the District is liable for an adverse reaction suffered by the student because of the sunscreen application or for discontinuing application at any time.
*
I have read and agree to the above statement.
Sunscreen product to be used, if specific
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Consent
Submit Consent
Should be Empty: