Parental permission form

Parental Permission Form Student Name _________________________
Field Trip

Yes,  my child has permission to go on school sponsored trips and activities outside of the classroom.    Cough Drops

Yes, I give my permission for my child to take cough drops at school.   Acetaminophen (Tylenol)

Yes, I give my permission for my child to take acetaminophen at school.   Ibuprofen

Yes, I give my permission for my child to take ibuprofen at school.  Antibiotic Ointment

Yes, I give permission for my child to have antibiotic ointment if they are injured.  Eye Drops

Yes,   I give my permission for my child to take eye drops at school.  Antacid (Tums)

Yes, I give my permission for my child to take Tums at school.   Hearing/Vision Screening

Yes, I give permission for my child to have vision and/or hearing screenings at school.  Spinal Screening (4th-8th Grade Only)

Yes, I give permission for my child to have a spinal screening at school.  Sharing of Health Information

Yes, I give permission for my child's health information to be shared by school health personnel with school employees directly involved with my child.   Dental Screening (Kindergarten and 9th Grade Only)

Yes, I give permission for my child to have a dental screen at school.  Puberty Movie (4th Grade Only)

Yes, I give my permission for my child to view, "The Always Changing Always Growing" puberty Safe Homes Directory (High School Only)

The Denison High School would like to announce a Parent Communication Network that consists of a group of parents that would like the cooperation and support of other parents to promote a safe environment for children to socialize. Parents who join the network agree to not allow the illegal consumption of tobacco or alcohol by youth under the legal age in their home, will not allow parties in their home when parents aren't present, and will not allow the use or presence of illegal Yes, I agree to the network guidelines listed above and would like to be included in the Denison High School Parents' Safe Homes Directory. I understand that my student's name(s), my name, address, and phone number will appear in the directory. I understand that the Denison Community School District and Denison High School claims no responsibility for any claims for damages or injuries which may result from activities conducted at the home of or at the direction of an individual member of the directory. Further the directory is not to be used for solicitation Internet

Yes,  I give permission for my child to have access to electronic communication known as the Internet and agree to abide by the school board policies and procedures outlining this access, as Media Release

Yes, I give my permission for my child to be photographed, video taped, and/or audio taped for school related purposes and activities. I also give permission for my child to be named, shown or pictured in the newspaper, on the radio or television in school related features. My child has permission to appear in school related public appearances.   Insect Repellant (Preschool Only)

Yes,   I give permission for my child to have insect repellant applied by school personnel, if needed, during outdoor school related activities if supplied by me.   Sunscreen (Preschool Only)

Yes,  I give permission for my child/children to have sunscreen applied by school personnel if needed during outdoor school related activities if supplied by me.  Parent Signature

Source: http://www.denison.k12.ia.us/documents/ParentalPermissionFormEnglish.pdf

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