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Non-Discrimination Statement
Chimacum School District does not discriminate in any programs or activities on the basis of sex, race, creed, religion, color, national origin, honorably discharged veteran or military status, sexual orientation, gender expression, gender identity, the presence of any sensory, mental, or physical disability, or the use of a trained dog guide or service animal and provides equal access to the Boy Scouts and other designated youth groups.  The following employees have been designated to handle questions and complaints of alleged discrimination:  
Civil Rights and Title IX Coordinator: Stephanie McCleary,  stephanie_mccleary@csd49.org, PO Box 278, Chimacum, WA 98325-0278, (360) 302-5894
Section 504/ADA Coordinator: Sarah Walker, sarah_walker@csd49.org, PO Box 278, Chimacum, WA 98325-0278, (360) 302-5823
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