In-Person Instruction Opt-Out Form

Parent’s must complete one form per child.

Child's First Name *
Child's Last Name *
Child's Date of Birth *
Child's grade in 2020-2021 *
Parent's Name *First & Last Name
Phone *
Email *
Does your home have working Internet Service? *
Consent *
By checking this box below, I am affirming that I am opting my child out of in-person instruction in response to the COVID-19 pandemic. I agree that I may not opt my child back into in-person instruction until the beginning of each marking period. To do so, I must notify the school of my decision for my child to attend in-person instruction by the deadlines of October 23, January 13, and March 30. I understand that my child must attend all scheduled virtual classes and must complete and submit all assignments by 11:59 PM on the due date of the assignment in order to receive credit for the assignment and to be marked present for school attendance on that day. I understand that all of the school's policies and procedures (e.g., grading, promotion and retention, attendance, discipline) still apply to my child as an enrolled student at Harambee Institute of Science and Technology Charter School.Opt Out of In-Person