San Diego Academy of Art and Science

6104 Adelaide Ave. San Diego, Ca. 92115 619-358-9408

Parent/Guardian Release Form

Please check the box or indicate NO for permission for the following:

My students is allowed to access the internet and use our chromebooks. He/she
understands the expectations outlined on the Computer Acceptable Use Policy found on
our school website.
Chromebooks need to be cared for and not damaged. Chromebooks are returned to the
charger daily before the student goes home for the day. I will immediately notify the school if
it is accidentally taken home. I will return it to the school ASAP for other students to use.
I give permission for my childs photo to be used in ___Academy publications, ____website,
and on ____social media.

Parent/Guardian:___________________________________________________Date:__________

Medication Administration
Long term medication: A Physician/Medication Authorization Form must be completed on a
yearly basis
Short term medications: Please see the office or website for specific instructions on giving
consent. Any medication that needs to be administered longer than 10 days must be
accompanied by a Physician's/Medication Authorization Form
Acetaminophen/Ibuprofen Permission Slip: The Academy will have both medications on
hand to provide students. However, before we can administer either medications there
MUST be a signed permission slip on file at the office. The office will call prior to giving your
child medication.

I understand the need for proper authorizations for the administration of medication

Parent/Guardian:___________________________________________________Date:__________

Medical Considerations
Are there any special medical conditions you would like the staff to be aware of?
If yes, please describe:
_______________________________________________________________________________

_______________________________________________________________________________

School Communication
We send out newsletters to keep you informed of events and important school updates. Our
website has many of these details as well. Our social media posts give you a fun peak in school
activities. At times we send Remind text Alerts with more urgent reminders/information.
I would like to receive Remind text alerts to the following cell number(s):

_______________________________________________________________________________