Vestavia Hills City Schools 2018-19 Voluntary Drug Testing Program Consent Form
Please complete this form to enroll your student in the Voluntary Drug Testing Program for the 2018-19 academic year.
You must complete this form for each student you wish to enroll in the Voluntary Drug Testing Program.
Student's School *
Student's Grade *
Student's Name *
Your answer
Parent/Guardian 1 Name *
Your answer
Parent/Guardian 1 Email Address *
Your answer
Parent/Guardian 1 Phone Number *
Your answer
Parent/Guardian 2 Name (optional)
Your answer
Parent/Guardian 2 Email Address (optional)
Your answer
Parent/Guardian 2 Phone Number (optional)
Your answer
Please click the link below to read the Voluntary Drug Testing Program information.
I have read and understand the Voluntary Drug Testing Program and have a copy of the information for my records. I understand that the $40 annual fee per child must be paid by August 31, 2017, and the fee must be paid at the beginning of each subsequent academic year. I understand that by completing this form, I agree for my child to participate in the Voluntary Drug Testing Program and he/she must participate when chosen. *
Required
I hereby waive, release and forever discharge all claims against Vestavia Hills City Schools, its Board of Education officers, agents, and employees, from any and all claims, demands, causes of action and obligations to me, my heirs, executors and assigns for any injury, loss, accident, or death during my participation in the Voluntary Drug Testing Program, including, but not limited to, that which may result from overdose, motor vehicle accidents, criminal acts, sickness, as well as any other risks that are not foreseeable. *
Required
Please enter your full name below. By typing your name here, you are signing this application electronically. You agree your electronic signature is the equivalent of your manual signature on this application. *
Your answer
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