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Code No. 603.10E1 Human Growth and Development Student Excuse Form

Human Growth and Development Student Excuse Form

Student Name:____________________________________ Grade:____________               

Parent/Guardian:__________________________________ Phone #:___________

Please list the curricular objective(s) from which you wish to have your child excused and the class or grade in which each is taught.  An example is provided for you to follow.

                                    Objective                                            Class/Grade

Ex.                   To understand the consequences of                Health Education/6

                        responsible and irresponsible sexual







I have reviewed the Human Growth and Development program goals, objectives, and materials and wish my child to be excused from class when these objectives are taught.  I understand my child will incur no penalty but may/shall be required to complete an alternative assignment that relates to the class and is consistent with assignments required of all students in the class.

Signed:_________________________________________ Date:___________________

                        (Parent or Guardian)

Signed:_________________________________________ Date:___________________

                        (School Administrator)


Revised/Reviewed: September 29, 2015