Sample Parental Consent Form

EdAction
Maple River Education Coalition PAC
105 Peavey Rd, St 116
Chaska, MN 55318
952-361-4931
http://www.EdAction.org
E-mail

To: Members of the School Board, Superintendent, Principals, Teachers, Counselors and Staff of ISD 831

I, William Dunbar Saxton am the natural & legal father of ____________ and ____________ who are enrolled in the ___ & ___ grade respectively within the ISD 831 school system.

This letter is a written, legal notice that I am exercising my rights under Federal law (20 U.S.C. §1232h), Minnesota State law, and Supreme Court case law to request that the above-named pupils be excused from and not attend or participate in any class(s), presentation(s), discussion(s), project(s), extracurricular activities, or program(s) presented by the school district or by the agent(s) under its direction, which involve any of the following:

· Sex or family life education; AIDS or HIV education; the acquiring or use of birth control drugs or devices; abortion; infanticide; death education in any form; programs regarding death; homosexuality; bestiality; sadism, masochism, or other sexual practices; showing of PG-13, R, NC-17 or X rated (pornographic) films; meditation, yoga, trances, guided imagery, or the conjuring of spirit guides and/or "imaginary friends;" witchcraft in any form; any counseling, group or individual, other than behavior modification programs, except as recommended by the student's personal physician and approved by me in writing, or:

· The use of questionnaires, role playing, or other strategies to question, expose, or criticize any private, religious or moral value of the above named pupil or members of his/her family; "values clarification," "decision making," or global education dealing with the aforementioned subjects, and:

· Any and all activities that teach as fact the unproven theory of cosmic evolution (big bang), chemical evolution (higher chemical), planetary evolution (origin of the stars), organic evolution (origin of life), or macroevolution (unobserved).

This notice applies NOT ONLY to direct sex, health, or family life education programs, but ALSO to any of the aforementioned subjects which may be infused or included as "part of any...course which pupils are required to attend" (this does not apply to description or illustration of human reproductive organs which may appear in a textbook, adopted pursuant to law, on physiology, biology, zoology, general science, personal hygiene, or health).

I expect to be notified of the presentation of materials and subjects as required by State statutes and of the approximate date of their presentation, so that I may exercise my right to inspect and review instructional plans and materials, for venereal disease, and sex education; and in order that I may monitor the exemption of the above-named pupil from classes or activities involving the aforementioned subjects.

I also expect to be notified of all tests, questionnaires, surveys or examinations containing any questions about the pupil's, or parent's personal beliefs or practices in sex, family life, morality and religion, so I may choose whether or not to give the requisite written permission necessary

I request that the principals and all teachers and/or other agents of the school district who are involved with the education of my above-named minor children be informed of this legal, written notice, and that they be made aware of the penalty of revocation or suspension of their certification for knowingly violating my rights as a Minnesota & US citizen.

The above requests are the result of our family's sincerely held religious beliefs, as well as the need to protect my child from possible physical, emotional, or psychological harm or trauma.

Additionally, I request written acknowledgment of receipt and filing of this legal, wri