MCS Opt Out for Masks

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Murfreesboro City Schools (MCS) has developed the following form allowing parents or legal guardians the option to opt their child out of requirements to wear a face covering at school.

Although Governor Lee has given all parents the right to opt out of their child wearing a mask at school and on the bus, the Center for Disease Control (CDC) recommends universal indoor masking in K-12 educational settings and has emphasized the importance of wearing masks to reduce transmission in schools.

Many school-aged children are not yet eligible to receive the COVID-19 vaccine. To ensure that students and teachers are able to safely participate in in-person instruction, it is recommended that all teachers, staff, and students and visitors wear masks and practice social distancing when possible.

By completing this form, you are giving permission for your student to not wear a face covering while at school.

A separate form must be completed for each student for whom you are giving permission.

Child's First and Last Name as it appears on Skyward *

Parent or Guardian Name completing this form *

Phone Number *

Student's Date of birth *

YYYY

Student's Grade *

School *

Student's Homeroom Teacher *

By checking the boxes below, I attest to the following:

1. *

I have signed this form freely and voluntarily and I am authorized to make decision for the student.

Required

2. *

I acknowledge that the CDC has recommended that students wear face coverings in the school environment to protect against the spread of COVID-19.

Required

3. *

I am aware that I have the opportunity to discuss with health care providers whether my child should wear a face covering.

Required

4. *

With the exception of face covering requirements, I understand that the student shall remain subject to all other school and school district requirements, including related to COVID-19.

Required

5. *

I understand that I may update this permission form for my child at any time.

Required

Parent/Guardian Initials *

A separate form should be completed for each child.

Submit

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This form was created inside of Murfreesboro City Schools.

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