MVSD COVID-19 Student Screening Consent/Opt-Out Form (2nd Semester)

The next COVID-19 screening sessions involving students are scheduled to take place after Mid Winter Break (February 19 or 23, 2021), as well as after Spring Break (April 13 or 15, 2021).

Please submit a separate response for EACH student you have enrolled in the MVSD. Thank you for your participation.

If you'd like more information on screening, please click here.

Thank you!

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* 1. LAST Name of Student:

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* 2. FIRST Name of Student:

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* 3. School:

Methow Valley Elementary

Independent Learning Center

Liberty Bell

REACH

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* 4. Grade of Student:

Kindergarten

Other (please specify)

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* 5. Parent/Guardian Name:

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* 6. All MVSD students have the opportunity to participate in the free, voluntary COVID-19 screening on February 19 or February 23, 2021, as well as April 13 or April 15, 2021. Please provide consent or opt-out below.

Provide consent for my student to participate in the free, voluntary MVSD COVID-19 Screening on February 19 or February 23, 2021, as well as April 13 or April 15, 2021.

Opt-out my student from participating in the free, voluntary MVSD COVID-19 Screening on February 19 or February 23, 2021, as well as April 13 or April 15, 2021.