Parental Declaration Form

Return to Educational Facility Parental Declaration Form

Creagh National School

Please ensure that you complete this form now for each pupil of Creagh N.S who will be returning to school after the Christmas break in January 2022.

This form will need to be filled in again when children are returning to Creagh NS after any absence.

We appreciate your co-operation in these matters.

* Indicates required field

Child's Name *

First

Last

Class *

Teacher: Select one *

1. I have no reason to believe that my child has infectious disease and I have followed all medical and public health guidance with respect to exclusion of my child from educational facilities.

Please Tick *

True

2. My child has not been identified as a close contact of a confirmed case.

Please Tick *

True

3. My child has not been advised by a doctor to self-isolate at this time.

Please tick *

True

.4. My child has not been advised to restrict their movements at this time.

Please Tick *

True

6. My child is not awaiting the results of a Covid-19 test.

Please Tick *

True

7. My child is not displaying any signs or symptoms of Covid -19.

Please Tick *

True

8. My child is not residing with anyone who is displaying symptoms of the virus.

Please Tick *

True

Please enter Parent or Legal Guardian's Name *

Declaration:
In order to ensure the continued and safe re-opening of schools and return of pupils, it is extremely important that parents complete these forms with accuracy.

Submit

You can also download the form HERE and fill it in by hand if you prefer

Please note: The school is collecting this sensitive personal data for the purposes of maintaining safety within the workplace in light of the COVID-19 pandemic. The legal basis for collecting this data is based on vital public health interests and maintaining occupational health and this data will be held securely in line with our retention policy.

Return to Educational Facility Parental Declaration FormCreagh National School

Return to Educational Facility Parental Declaration Form

Creagh National School