SCIENCE Safety Code of Conduct - PARENTS
Dear Parent/Guardian,

We feel you should be informed about the school’s effort to create and maintain an orderly and safe science classroom/laboratory environment. A safety instruction program can eliminate, prevent, and correct possible hazards with the cooperation of the instructor, parents or guardians, and students.

You should be aware of the safety instructions your student will receive before engaging in any laboratory or field-based work. Please read the list of safety rules outlined in the Student Safety Code of Conduct. No student will be permitted to perform the required laboratory activities unless both the student and yourself sign this code of conduct.

Your submission of this form indicates you and your student have read the Student Safety Code of Conduct, are aware of the measures taken to ensure the safety of your student science class, and will instruct your student to uphold their agreement to follow the Student Safety Code of Conduct.

Please read the Science Safety Code of Conduct here:
https://drive.google.com/file/d/0B6qX_Pla2fXJb2xrWjQxMVBFNlE/view?usp=sharing

Student Name (Last, first) *
Your answer
Parent Name (Last, first)
Your answer
Please select your Instructor *
Please indicate any of the following medical conditions are applicable to your student. This information is confidential, will remain as such, and will be important for best safety practices while in science class
Please list your student's specific allergies, if applicable.
Your answer
Please list other relevant medical conditions that are not listed above
Your answer
My student agrees to follow all the safety rules set forth in the Student Safety Code of Conduct. Students must follow this code of conduct to ensure their own safety and that of their fellow students and instructors. My student will cooperate to the fullest extent to maintain a safe lab environment. My student and I recognize that any violation of this Student Safety Code of Conduct will result in loss of citizen points, an administrative intervention, a failing grade, and/or dismissal from the course. *
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