ANNUAL WAIVER OF LIABILITY FOR Student Self-Administration of Medications - LINK TO JGFGB

ANNUAL WAIVER OF LIABILITY For Student Self-Administration of Medications - Printable Version

Reference - Board of Education Policies:  

• JGFGB – Supervision of Medications, rev. 03/08/2016  
• JGFGBA – Student Self Administration of Medications, rev. 02/13/2017  
• JGFGBB – Accommodating Students with Diabetes, rev. 06/08/2015  

Annual Waiver of Liability

By my signature below, I acknowledge that the school district and its officers, employees, or agents incur no liability for damage, injury, or death resulting directly or indirectly from my student’s self-administration of medication and agree to release, indemnify, and hold the district and its officers, employees, and agents, harmless from and against any claims relating to the self-administration of medication allowed by these policies.              

Parent/Guardian Signature                                                                                                                     Date              

Witnessed by                                                                                                                                           Date