Gooding Jt. School District No. 231
INSTRUCTION 2580F
Student Permission for Exposure to Animals(s)
To be used when animal(s) are brought into the classroom or learning center for educational purposes.
Student: Grade/Teacher:
Dear Parent(s)/Guardian(s):
As allergies, asthma, immune problems, and/or other health concerns may make animal contact inappropriate for some students, District guidelines require prior parent/guardian permission for student contact with animal(s) in school.
On (insert date) , the following animal(s) will visit my classroom for educational purposes:
Cat Guinea Pig Hamster Mouse
Bird Dog
Reptile or amphibian Gerbil
Ferret Rabbit Rat
Other
The following animals are prohibited in schools:
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Venomous or toxin-producing animals (e.g., certain spiders, insects, reptiles, and amphibians);
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Wild or exotic animals;
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Mammals at high-risk for transmitting rabies (e.g., bats, raccoons, skunks, foxes, and coyotes);
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Non-human primates;
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Stray animals;
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Aggressive or unpredictable animals;
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Any animal in the Idaho Invasive Species List; and
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Any animal considered inherently dangerous.
The building principal or designee will ensure that the District’s policies and procedures for the use of animals in education programs are followed. I will also supervise the entire student- animal contact session, have a clean and disinfected area for showing the animal(s), not allow food or drink in the animal showing area, and will appropriately dispose of animal waste. Under no circumstances are students allowed to clean cages or handle animal waste.
Please complete and return this form to me by (insert date) . If you have any questions or concerns, please feel free to contact me at (insert contact information)
.
To Be Completed by Parent/Guardian:
I do permit my student identified above to be exposed to the animal(s) listed above. I further agree to indemnify and hold harmless the School District and its employees and agents against any claims, except a claim based on willful and wanton conduct, arising out of my student’s exposure to the animal(s) listed above.
I do not permit my student identified above to be exposed to the animal(s) listed above. I understand that when the animal(s) listed above are present, my student will be excused from classroom attendance without penalty and given an alternative educational activity.
Parent/Guardian Name (please print)
Parent/Guardian Signature Date
Parent/Guardian Name (please print)
Parent/Guardian Signature Date
Note: If only one parent/guardian signs this form, please certify the following:
I, (parent/guardian), have full authority to sign and consent to this Permission Form and Release as an agent of any and all other parent(s) and/or legal guardian(s).