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Student Ministry
Parent Consent | Health Screen
Please fill out the form below if you have a student attending either CORE or The Summit.
PARENT CONSENT
I acknowledge that I have read and understand the communicated guidelines in response to COVID-19 and the re-opening of Pathfinder Students at Pathfinder Church.
Having read the Pathfinder Re-entry plan, I give my informed consent for my child(ren) attending.
I agree to screen my child(ren) at home and keep them from attending if they have the symptoms related to COVID-19, including but NOT limited to:
• Headache
• Fever of 100.4 F or more, chills, or sweating
• Cough, shortness of breath or difficulty breathing
• Sore throat
• Muscle pain or body aches
• New loss of taste or smell
• New rash
• Nausea, vomiting, diarrhea
• Chest congestion or unusually runny nose
• Unexplained fatigue or lack of energy
I will inform the ministry if my child has had any close contact with an individual diagnosed with COVID-19 or if we have traveled internationally or to a COVID-19 hot spot.
I agree to follow current guidelines and to be as supportive of Pathfinder Students as they strive to make the best possible environment for student’s health, safety, and learning.
Signature of Parent / Guardian
*
First
Last
Date
*
MM slash DD slash YYYY
Consent
*
I accept
Child(ren) Names
*
Include BOTH First and Last Name
Δ