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ALLERGIES/CONSENT FORM (ALL)

Please complete the form below. Required fields marked with an asterisk *

Child's Full Name*

Answer required for "Child's Full Name"

Class*

Answer required for "Class"

ALLERGIES*

Please type "none," if not applicable. A list of all food related allergies will be posted in every classroom for safety purposes.

Answer required for "ALLERGIES"

Prescribed Treatment (Epi Pen, Benadryl...)*

When you bring your child's medication to school, you will be asked to complete and sign a "Medication Administration Form" that will be kept with the medication at all times.

Answer required for "Prescribed Treatment (Epi Pen, Benadryl...)"

Any other food related restrictions*

Answer required for "Any other food related restrictions"

SUNSCREEN: I authorize school staff to apply sunscreen prior to any outdoor time.*

Answer required for "SUNSCREEN: I authorize school staff to apply sunscreen prior to any outdoor time."

Yes

PHOTO/VIDEO RELEASE: I authorize 2nd Presbyterian Weekday School to display photographs of my child and/or family in newsletters, professional publications, school website, etc. Videos may be used at teacher in-services and/or as observational tools for assessment.*

Answer required for "PHOTO/VIDEO RELEASE: I authorize 2nd Presbyterian Weekday School to display photographs of my child and/or family in newsletters, professional publications, school website, etc. Videos may be used at teacher in-services and/or as observational tools for assessment."

Yes

ON SITE/OUT OF CLASSROOM RELEASE: I authorize my child to participate in learning activities outside of the classroom that are on the Church premises. (i.e. nature walk, visit to Great Hall, Fellowship Hall, other classrooms)*

Answer required for "ON SITE/OUT OF CLASSROOM RELEASE: I authorize my child to participate in learning activities outside of the classroom that are on the Church premises. (i.e. nature walk, visit to Great Hall, Fellowship Hall, other classrooms)"

Yes

CLASSROOM PET RELEASE: I authorize my child to be in the presence of the school's pets and educational programs with animals. (Classroom pets may include gerbils, guinea pigs, hamsters, goldfish, turtles, birds, rabbits, and butterflies. Educational organizations such as the Louisville Zoo or Silly Safari may bring other types of animals in cages.)*

Answer required for "CLASSROOM PET RELEASE: I authorize my child to be in the presence of the school's pets and educational programs with animals. (Classroom pets may include gerbils, guinea pigs, hamsters, goldfish, turtles, birds, rabbits, and butterflies. Educational organizations such as the Louisville Zoo or Silly Safari may bring other types of animals in cages.)"

Yes