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.
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.
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.
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:
other than parent/guardian: __________________________________________
_______________________ Phone number: ___________________________
doctor name: ___________________________ Phone number: ____________________
your child require any special accommodations due to medical limitation, allergies,
disabilities, dietary constraints, or other restrictions? Please explain any
that are required.
day time phone contact
Parent/Legal Guardian Signature Date