FSA Attendance/Absence Form

Attendance/Absence Form
Date*

YearMonthDay
Child's Name*

First NameLast Name
Child's Classroom*

Athabasca FallsBow FallsCastle Falls - KindersCrescent FallsElbow FallsFossil FallsHorseshoe Falls
Child's Classroom
Parent*

First NameLast Name
Email*
example@example.com
Phone Number*
Date Expected Back*

YearMonthDay
Comments*
Reason*
I understand and agree that if my child is absent due to illness or symptoms of illness, they will not return to care until they have been symptom-free for 24 hours from the start of symptoms.*

Yes, I agreeNo, I do not agree
In an effort to be very cautious about ensuring we are aware of illnesses in Steps Academy, we are asking parents to provide additional information regarding symptoms their child has when they are absent due to illness. Please ensure you are sharing everything you can so we can do everything needed to continue to kee our children, families and staff sick and to avoid any disruption in care for everyone.

Everyone's cooperation is very much appreciated!
My child's symptoms*

CoughSore ThroatRunny NoseFeverLethargicStomach painDiarrheaHeadacheThrowing upUpset Stomach (No throwing up)Blood in diarrheaOther
If you selected other, please list any other symptoms your child has:*
Date Leaving Alberta

MonthDayYear
Date Returning to Alberta

MonthDayYear
First day of symptom(s)

MonthDayYear
Date
Estimated date of contact*

MonthDayYear
Date
Date of Positive Test*

MonthDayYear
Last Date of Attendance at Steps Academy*

MonthDayYear
Please verify that you are human*
I understand that individuals with cough, fever, runny nose, sore throat or shortness of breath are required to isolate for 10 days as per CMOH Order 05-2020 AND all symptoms are gone (which may be longer than 10 days) OR until they receive a negative Covid test result AND all symptoms are gone (which may be longer than 10 days).

If NO Covid test is taken, care may only resume after TEN (10) DAYS from start of first symptom and once ALL SYMPTOMS ARE GONE.

Children returning with symptoms will not be accepted or will be sent home.

Children with pre-existing conditions documented on file with Steps Academy, may return to care without Covid testing once they are well enough to attend and have no contagious symptoms.
Other Notes/Details
Should be Empty: