2140F Student and Family Privacy Rights Consent Form - Cascade ...

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eview these materials. You have the right to review a survey and/or instructional materials

before the survey is administered to a student.

I ______________ [PARENT/GUARDIAN’S NAME] give my consent for _____________

[CHILD’S NAME] to take __________________ [SURVEY NAME] on or about

___________ [DATE].

Parent’s signature: _________________________

Please return this form no later than ___________ [DATE] to the following school official:

[NAME AND MAILING ADDRESS]

Adopted: 2/13/2013

2140-2 (ISBA 10/12 UPDATE)

2570F Parental Opt-Out/Consent Form Re - Cascade School District

eview these materials. You have the right to review a survey and/or instructional materials before the survey is administered to a student. I ______________ [PARENT/GUARDIAN’S NAME] give my consent for _____________ [CHILD’S NAME] to take __________________ [SURVEY NAME] on or about ___________ [DATE]. Parent’s signature: _________________________ Please return this form no later than ___________ [DATE] to the following school official: [NAME AND MAILING ADDRESS] Adopted: 2/13/2013 2140-2 (ISBA 10/12 UPDATE)

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