PARENTAL RELEASE

Dear Parents,

In order for a student to participate in shop-related courses in the Paulding County School District, it is necessary for him/her to have school insurance or a release form signed by you stating that he/she is covered under your personal health insurance policy. If for any reason this information changes during the school year, please contact your child’s instructor or the school’s CTAE Supervisor to inform them of changes.

Please sign this release and return it to his/her instructor so that your child will be able to participate in shop/lab classwork.

RELEASE

This is to certify that _________________________________________________ is

(Name of Student)

covered under school insurance or is covered under our personal health insurance policy.

__________________________________________

Parent's Signature

__________________________________________

Date of Signature

Please list any food allergies here: