ABSS COVID-19 Parent/Guardian Attestation
Parents/Guardians of all ABSS students (Pre-K through 12) who will be on a school campus for in-person learning, or for specific athletic or extracurricular activities, must complete this required form per guidelines outlined by the North Carolina Department of Health and Human Services (pages 19 and 20).
Please complete this form for each child before he/she/they return to campus.
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Alexander Wilson Elementary
B. E. Jordan Elementary
E. M. Holt Elementary
E. M. Yoder Elementary
Grove Park Elementary
Haw River Elementary
North Graham Elementary
Pleasant Grove Elementary
South Graham Elementary
South Mebane Elementary
Ray Street Academy
Alamance-Burlington Early College @ ACC
Please select your child's grade level.
Child's First Name
Child's Last Name
I will not send my child to school if he/she/they have had close contact (been within 6 feet of someone diagnosed with COVID-19 for a cumulative total of 15 minutes over a 24-hour period) in the last 14 days, or if any health department or health care provider has been in contact with me/my child and advised quarantine.
I understand, and I will not send my child to school if he/she/they have been in close contact or advised to quarantine.
I will not send my child to school if he/she/they have any of the following symptoms: fever, chills, shortness of breath or diffculty breathing, new cough, new loss of taste or smell.
I understand, and I will not send my child to school if he/she/they have any of the symptoms listed above.
I will not send my child to school if he/she/they have been diagnosed with COVID-19, until they meet the return to school criteria outlined below.
I understand, and I will not send my child to school if they have been diagnosed with COVID-19 until he/she/they have met the return to school criteria outline below.
A child can return to school when a family member can ensure that they can answer YES to ALL three questions: 1-Has it been at least 10 days since the child first had symptoms? 2-It has been at least 24 hours since the child had a fever (without using fever reducing medicine)? 3-There has been symptom improvement, including cough and shortness of breath?
I understand that we must be able to answer YES to ALL three questions above before our child returns to school if they've been unable to attend due to COVID-19 precautions.
By signing below, I attest to the following:
1. I will screen my child every morning, every day, for the 2020-21 school year and will NOT send my child to school if the answer to any of the questions above is YES.
2. By sending my child to school on any given day, I certify that I have screened my child on that day and the answer to ALL of the questions above is NO.
3. If my child is diagnosed with COVID-19, I will not send my child back to school until they meet the criteria for return.
Please list your first and last name below to indicate that you are the parent/guardian of the child and that you understand and agree to the information contained within the attestation form. This serves as your electronic signature that you have read and understand these requirements.
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This form was created inside of Alamance Burlington School System.