1.) By reading and signing this form, I authorize my student/s in the Montrose School district to be given the non prescription medications identified below. These medications will be administered by the school nurse (Sara Bartlett, RN). 

2.) As the parent or guardian of the child/children listed below I hereby release the Montrose School district, its employees and agents from liability for injury that may arise from the administration of these medications while on school property. 

3.) I understand that the school may inform other school employees, who have a need to know, such as other teachers and administrators.

4.) I understand that medications should not be stored in the student's locker/backpacks and will be given to the school nurse to be locked in a secure cabinet and will be administered at the student's request.  

5.) I acknowledge and agree to the above statement. I understand that I will still be contacted by the school nurse and will receive documentation regarding medication administration.