Parent Consent for Hand Sanitizer Use

Please provide information on your child(ren) regarding any restrictions for the use of hand sanitizer. Please complete this form for each child enrolled in the district.

Hand Sanitizer Use in Schools

Dear Parent/Guardian,

In light of the ongoing Global Pandemic, in an effort to prevent the spread of germs, Montgomery Public Schools will be utilizing hand sanitizer district wide regularly throughout the day. Realizing some students are not able to use hand sanitizer because of a medical concern, please carefully read and respond below.

NOTE: Complete this form for each child enrolled in Montgomery Public Schools. Thanks for your feed back.

Please indicate below:

Student Last Name *

Student First Name *

Please select school *

Grade Level *

My child, as needed throughout the day: *

YES, may use hand sanitizer without restriction

NO, MAY NOT use hand sanitizer without restriction

If you checked "No", please explain. If you checked "Yes", type NA *

Thanks in advance for your cooperation and feedback.

Dorothy Rogers, RN
District Nursing Coordinator

Submit

Never submit passwords through Google Forms.

This form was created inside of Montgomery Public Schools. Report Abuse

Forms