In-Person Learning Waiver
FRANKLIN PHONETIC ELEMENTARY CHARTER SCHOOL
Covid-19 Waiver, Release, and Assumption of Risk Form
The Coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Nevertheless, the Governor of State of Arizona issued Executive Orders 2020-41, 2020-44, and 2020-51 which provide that beginning August 17, 2020 charter schools are to begin free on-site learning opportunities and support services for students who need a place to go during the day and to provide on-site learning opportunities and support services including in-person support services such as student supervision and strategic support for students in need during standard school hours, which may include teacher-led or paraprofessional support for students with distance learning instruction. Franklin Phonetic Charter School (“School”) has put in place protective measures to reduce the spread of COVID-19, however, the “School” cannot guarantee that your child will not become infected with COVID-19. Your child’s physical attendance at school, together with other students, inherently increases the risk that your child, you, and/or your household members will contract COVID-19, notwithstanding any precautions taken by the school.
Please type your student's FIRST NAME.
Please type your student's LAST NAME.
Please type your child's DATE OF BIRTH. (month, day, year)
Please select your child's grade level.
Franklin Phonetic School will begin the hybrid program on Monday, October 19, for students in 5th -8th grades. Based on your survey input, if you chose to have your student(s) return to in-person learning, you MUST sign a waiver if your child will be returning to campus. The details of the waiver will be on the next page of this form. By completing and electronically signing this form, you are agreeing to the terms set forth in the form. The waiver is also available at
if you would rather print, sign and return the form in person.
I agree to the terms of the waiver.
I do not agree to the terms of the waiver.
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This form was created inside of Franklin Phonetic Primary School.