Therapy Dog Permission Form
Below, please fill out the e-permission slip indicating whether or not your child has your consent to be in a classroom visited by the Circleville Elementary School therapy dog in 2020 as a part of our new student wellness program. Forms due January 10th, 2020.
Student First Name:
Student Last Name:
Circleville Elementary will be hosting “therapy” dog’s visits. This volunteer program gives students the opportunity to interact with trained registered therapy dogs while at school. Handlers and their dogs will work with small groups of students during school hours for approximately 10-15 minutes. This signed Parental Permission Slip is required to participate in these events.
I, GIVE, permission for my child to participate in therapy dog visits at Circleville Elementary School.
I, DO NOT GIVE, permission for my child to participate in therapy dog visits at Circleville Elementary School.
Does your child have an emotional or physical sensitivity to dogs? If so, explain. If not, skip.
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This form was created inside of Circleville City Schools.