PUSD Health and Safety Agreement
I have read, understood and agree to the terms and conditions outlined in the Poway Unified School District Parent/Guardian Health and Safety Agreement for In-Person Instruction for the 20-21 School Year.

Please see the complete Health and Safety Agreement PDF linked in the Weekly Wildcat.

I understand that by signing this Google Form, I will be signing the Health and Safety Agreement in lieu of signing the physical form.
Email address *
Student Name (First and Last) *
Student Name #1 (First and Last)
Teacher #1
Student Name #2 (First and Last)
Teacher #2
Student Name #3 (First and Last)
Teacher #3
Student Name #4 (First and Last)
Teacher #4
Student Name #5(First and Last)
Teacher #5
Parent/Guardian Name (First and Last) *
Parent/Guardian Signature and Date *
A copy of your responses will be emailed to the address you provided.
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