Otsego Elementary School Faculty Handbook - Half Hollow Hills

CONSENT TO RELEASE PERSONAL INFORMATION
Half Hollow Hills
Central School District
September 2005
Dear Parent or Guardian:
You have notified the school district that your child has a food allergy. We would
like to notify the parents in your child’s class of this allergy, so that they can make
responsible choices when sending in food and/or snacks.
Please complete the form below and return to your child’s teacher as soon as
possible.
Thank you for your prompt attention to this matter.
Child’s Name:
_______________________________________________________________
____I hereby grant permission to the Half Hollow Hills School District to use my
child’s name when notifying the families of my child’s classmates of my child’s
food allergy.
______________________________
_________
Parent/Guardian Signature
Date
____I do not grant permission to the Half Hollow Hills School District to use my
child’s name when notifying the families of my child’s classmates of my child’s
food allergy.
______________________________
_________
Parent/Guardian Signature
Date
Please return this form to your child’s teacher.