St. Mary's CBS Return to Educational Facility Parental Declaration Form February 2021

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Please complete and submit the following form ahead of your child returning to St. Mary's CBS following an absence. For multiple pupils please complete and submit a separate form for each.

Narcis Daniel Michel Beck Mihai *

Parent's/Guardian's name *

Class pupil is returning to *

1st Class Ms Moroney

1st Class Ms Peters

2nd Class Ms Powell

3rd Class Mr Power

3rd Class Ms Flynn

4th Class Mr Morris

5th Class Ms Healy

5th Class Ms Stewart

6th Class Ms Traas

6th Class Mr Leahy

Cherry Blossom ASD preschool

Declaration: I have no reason to believe that my child has infectious disease and I have followed all medical and public health guidance with respect to exclusion of my child from educational facilities *

Agree

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