For Families » Acknowledgement and Disclosure Form

Acknowledgement and Disclosure Form

Due to your student returning to in-person instruction please print and sign the appropriate COVID-19 Parent / Guardian Acknowledgement and Disclosure Form from the links below and return it to the school office by March 26th.

Acknowledgement and Disclosure Form
致谢和披露表格的中文翻译
español del formulario de reconocimiento y divulgación

This form is required for all students who will return to in person instruction on campus and must be signed and returned to our office in person. We will have extra blank copies available in the front office for your convenience.

We must have this form in our office before your student returns to campus, or your student will not be allowed to attend classes on campus. Please return it by March 26th.

We are unable to accept mailed and electronic copies.

Our office hours are: Monday through Friday, 7:30AM to 4:00PM.

Should you have any questions or concerns please contact Alicia Mendoza at amendoza@cv.k12.ca.us