Parent Contact Information

Please provide telephone numbers at which you may be contacted during the day or evening hours:

For Student

I hereby acknowledge that I have been notified of the district policy FNF(LOCAL) as related to the STUDENT DRUG TESTING PROGRAM that may be accessed on the district website. I further acknowledge that I understand the provisions of the policy, and I hereby consent to any such testing as may be authorized by the District in accordance with said policy. I further understand that, because the tests are to be conducted on a random basis, I may be selected for testing more than on.ce each year-, and that refusal to submit to such tests may be grounds for action as specified in the policy.

Pursuant to the Texas Uniform Electronic Transmissions Act, an electronic signature has the same legal effect as a manual or handwritten signature. An electronic signature will not be denied legal effect or enforceability solely because it is electronic, and any requirement for a signature is satisfied by an electronic signature. By submitting an electronic signature, the individual identified and providing the electronic signature herein verifies acknowledgement of the binding legal effect and enforceability of the electronic signature. By clicking the box beside "I agree", you agree that this is valid as your signature. You hereby swear that you are the above named student and that the information is accurate to the best of your knowledge.

For Parent or Guardian

I hereby .acknowledge that I have been notified of the district policy FNF(LOCAL} as related to the STUDENT DRUG TESTING PROGRAM that may be accessed on the district website. I do hereby consent that my child n:iay participate in any such testing as may be authorized by the District in accordance with said policy. I understand_ that I may withdraw the authoriz_ation for testing at any time.upon submission of written notice to ??he scliool Principal. I further understand and accept that, tfpon such withdrawal, my child will become ineligible to participate in any of the activities as may be specified-in the p·olicy until such time as authorization to test is restored. Further, I hereby release and hold harmless the Brazosport Independent School District and the Testing Service, and their trustees, officers, employees, agents, and representatives from any and all liability, claims, damages and costs that may arise as a result of any action as may be taken relative to a positive drug/alcohol test.

Pursuant to the Texas Uniform Electronic Transmissions Act, an electronic signature has the same legal effect as a manual or handwritten signature. An electronic signature will not be denied legal effect or enforceability solely because it is electronic, and any requirement for a signature is satisfied by an electronic signature. By submitting an electronic signature, the individual identified and providing the electronic signature herein verifies acknowledgement of the binding legal effect and enforceability of the electronic signature. By clicking the box beside "I agree", you agree that this is valid as your signature. You hereby swear that you are the parent or legal guardian of the above named student and that the information is accurate to the best of your knowledge.