Parent/Guardian Acknowledgement & Attestation Form 2020


  1. I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and manyother public health authorities still recommend practicing social distancing and wearing face masks when distancing is not possible.
  2. I further acknowledge that SAU #70 schools have put in place preventative measures to reduce the spread of the Coronavirus/COVID-19 while students are in school buildings.
  3. I further acknowledge that SAU #70 cannot guarantee that my child will not become infected with the Coronavirus/Covid-19. I understand that the risk of my child becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or oversights of multiple entities and interactions, not only when attending in-person schooling.
  4. I acknowledge that I must comply with all procedures set forth by current CDC, New Hampshire Department of Health and Human Services, and Vermont Department of Health guidelines to help reduce the spread of coronavirus while my child attends school.


  1. I agree to promptly notify the school health office if  my child or a live-in family member either test positive for, or is diagnosed with, COVID-19.
  2. I will keep my child home from school in the event they are experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, 100.4 or higher temperature, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell, nausea, vomiting or diarrhea (also runny nose and nasal congestion that cannot be attributed to a known underlying health condition in Vermont).

  3.  If my child attends school in N.H. we  will follow the current N.H. state travel guidelines. These are that no travel is allowed outside of the New England States (Maine, Vermont, New Hampshire, Massachusetts, Connecticut and Rhode Island). If they do travel outside they must self quarantine for 10 days. It is also possible to obtain a PCR COVID test on day 6 or 7 and if negative they may return on the 8th day.

  4.  If my child attends school in Vermont we will follow the current Vermont state travel guidelines. Any travel outside of Vermont requires a 14 day self quarantine. Students may obtain a PCR COVID test on or after day 7.  If they remain without symptoms and they test negative, then they may return to school.

  5.  If my child is exposed to an individual who tests positive for COVID-19 they will self quarantine for 10 days. It is recommended that they are tested 5-7 days after exposure, however they still must complete the 10 day self quarantine.

  6. Everyone in our household, including my child and live-in family, is following all current CDC recommended guidelines as much as possible and limiting our exposure to the Coronavirus/COVID-19.

  7. My student will not gather with other people outside of our household (for VT).

  8.  I agree to conduct daily symptom screenings (listed above) prior to my child/children boarding a bus, car pool, or entering school buildings.

  9. I agree that my child will wear a mask as required while at school

    Parent/Guardian Signature________________________________________
    Parent/Guardian Print Name ______________________________________
    Child (Children’s Names) __________________________________________
    Date _________________________________________________________


SAU 70 – Dresden, Hanover, & Norwich School Districts updated 1/19/2021