Acknowledgement of Liability/Medical Release Form

To Enroll:

  1. Download and complete Immunization Form (new students)
  2. Complete the online Medical Release Form (all students) and upload the completed Immunization Form
  3. Read the Student Standards and Procedures
  4. Mail or submit online form with $75.00 (per student) administrative fee to Basic Skills.
  5. Once completed forms and administrative fee are received, Enrollment Forms will be sent via email

If you do not wish to complete the online form, you may print and manually complete the PDF version of the Medical Release Form.

Acknowledgement of Liability / Medical Release


  • This form is valid through August of 2018


    In case of a medical emergency, I hereby give consent for my child’s teacher or any Basic Skills’ personnel to treat or seek medical or dental treatment for the student(s) named below.

    I acknowledge that the teachers at Basic Skills are only responsible for each student during the attendance of his/her scheduled class(es). At all other times, the responsibility for the student resides with the parent/guardian.

  • Students

 

Medical Information

 

Secondary Emergency Contact

 

Student Health Information

  • Download this Immunization Form and upload with information completed.
    Alternately, you can claim a non-medical exemption here and upload your record of completion.
 

Verification