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RA COVID Testing Consent Form

Please complete the form below regarding COVID-19 Testing at Renaissance Academy Charter School of the Arts. This form must be completed by Monday, November 16, 2020 at 8am.
1.Parent/Guardian Name:(Required.)
2.Parent/Guardian Phone Number:
3.Parent/Guardian Email:
4.Student(s) First and Last Name and Grade Level:
(i.e. Cait Loury - Grade 4)

Please type all names if multiple children attend RA.
5.Check the box if your child was already 100% virtual as of 11/12/20.
6.By selecting "yes" below, I attest that:

  • I have signed this form free and voluntarily, and I am legally authorized to make decisions for the child named above.
  • I consent for my child to be tested for COVID-19 using the rapid nasal-swab test.
  • I understand that my child will be tested approximately once per month while we are in the yellow zone.
  • I understand that this consent is valid through the end of the 2020-2021 school year unless I notify the school in writing that I revoke my consent. 

I understand if I do not consent to COVID-19 testing that my child will transition to 100% virtual instruction.

Do you give consent for your child(ren) to receive periodic COVID testing?(Required.)