Common use of Parent Signature Clause in Contracts

Parent Signature. Yes, I give consent for Jefferson School District to access my public benefits for my child’s health services. No, I do not give consent for Jefferson School District to access my public benefits for my child’s health services. If you do not wish directory information released, please sign where indicated below and return to the school office within the next 30 days. Note that this will prohibit the District from providing the student’s name and other information to the news media, interested schools, parent-teacher associations, interested employers, and similar parties. Do NOT release directory information regarding (Pupil’s Name) □ Check if an exception may be made to include student information and photos in the yearbook. I hereby acknowledge receipt of information regarding my rights, responsibilities, and protections . Student Signature Date Parent/Legal Guardian Signature Date

Parent Signature. Yes, I give consent for Jefferson School District to access my public benefits for my child’s health services. No, I do not give consent for Jefferson School District to access my public benefits for my child’s health services. If you do not wish directory information released, please sign where indicated below and return to the school office within the next 30 days. Note that this will prohibit the District from providing the student’s name and other information to the news media, interested schools, parent-teacher associations, interested employers, and similar parties. Do NOT release directory information regarding (Pupil’s Name) □  Check if an exception may be made to include student information and photos in the yearbook. I hereby acknowledge receipt of information regarding my rights, responsibilities, and protections . Student Signature Date Parent/Legal Guardian Signature Date