Parent/Guardian Request for Student Exclusion from Eclipse 2017 Activities
On Aug., 21st, 2017 all MPS students in grades 1-12 will have the opportunity to go outside to view the eclipse using eclipse safety glasses meeting ISO 12312-2:2015. If you would like to opt your student out of this experience you must complete this form.

Completing this form does NOT opt a student out of school on August 21st. Should a student need to be absent that day, a parent/guardian will need to contact the school office directly.

Email address
Individual Requesting Exclusion
Include first and last name.
Your answer
Name of Student
First and last name
Your answer
Your School Name
Select One
Please indicate your wishes regarding your child's level of participation in eclipse activities on August 21, 2017.
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Never submit passwords through Google Forms.
This form was created inside of Millard Public Schools. Report Abuse - Terms of Service - Additional Terms