FRANKENMUTH HIGH SCHOOL

Parent/Guardian Consent For Job Shadowing

Teachers to complete:  Teachers authorize students to be excused from their class for a job shadowing experience. Students will be responsible for all make-up work and will complete it according to a schedule determined by the student and each teacher. If a teacher feels a student cannot afford to miss class, state so under remarks so that parents will know in advance.

CLASS/HOUR:                                    TEACHERS SIGNATURE:                  REMARKS:

1. ____________________________________________________________________________

2. ____________________________________________________________________________

3. ____________________________________________________________________________

4. ____________________________________________________________________________

5. ____________________________________________________________________________

6. ____________________________________________________________________________

To parents/guardians: If you would like your child to participate in this event, please complete, sign, and return this statement of consent, prearranged absence permission, medical authorization, and release of liability. As a parent or legal guardian, you remain fully responsible for any legal responsibility, which may result from any personal actions taken by the named student.

I hereby consent to participation by my son/daughter in the job shadowing event described above. I understand that this event will take place away from high school and that my child will be under the supervision of an assigned adult participant. A school staff person will NOT be accompanying the student on the job shadowing experience. I further consent to the conditions stated above on participation in this event, including the method of transportation.

Should it be necessary for my son/daughter to have medical treatment while participating in this event, I hereby give the school district and/or worksite personnel permission to use their best judgment in obtaining medical service for my child, and I give permission to the physician selected to render whatever medical treatment he/she deems necessary and appropriate. Please provide the following contact information:

Contact other than parent/guardian: __________________________________________

Relation: _______________________ Phone number: ___________________________

Family doctor name: ___________________________ Phone number: ____________________

Does your child require any special accommodations due to medical limitation, allergies, disabilities, dietary constraints, or other restrictions? Please explain any that are required.

______________________________________________________________________________

___________________                      ________________________________                    ____________

Your day time phone contact                    Parent/Legal Guardian Signature                                    Date