Forms

Self Carry Medication Permission Form available from the nurse

Maturation Opt Out Form

Brushy Creek Elementary School

Date: March 10, 2017 (Friday before spring break)

Dear Parents/Guardians:

As part of the RRISD 4th and 5th grade health Texas Essential Knowledge and Skills requirements, classes on maturation and hygiene will be provided for 4th & 5th grade students. This curriculum was developed and written by district administrators, teachers, counselors, nurses, parents, and community resource people. Boys and girls will be separated for the instructional program. Students returning the OPT OUT form (below) will be sent to an alternate location in school during this instructional program.

For 5th grade Girls & Boys and 4th grade Girls: The focus of the maturation program is on the physical and emotional changes that take place in adolescents during puberty. The DVD/video, "Always Changing”, is an age appropriate video for girls and boys that describe these changes in a sensitive manner. Boys and girls will be separated for the instructional program and will view the “GIRLS ONLY” or “BOYS ONLY” version of the DVD/Video. We will be showing the original version of the videos.

You can preview the DVD/video and course materials at:http://www.pgschoolprograms.com/parents.php

For 4th grade Boys: The focus of the 4th grade boys program is on the development of personal grooming and hygiene habits as they mature. The video "Whatsa Hygiene?" will be shown to the boys.

You can preview a portion of the DVD/video at:

http://www.marshmedia.com/online/product_desc.cfm?ordernum=9221IN&cat=hhd

The DVD/videos and discussions will take place at school on March 10, 2017.

Students returning an OPT OUT form will be sent to an alternate location in school during this instructional program.

Please feel free to contact the school health clinic at: 512-428-3006 with any questions.

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OPT OUT Form

(Return this form only if you do NOT wish your child to participate in the Maturation/Hygiene program)

Name of Student:________________________________

Teacher’s Name:_________________________________

My child, ______________________, does NOT have permission to participate in the above stated instructional program. I understand that he/she will be sent to an alternate location in school during this instructional program.

_______________________________________ ______________________

Parent/Guardian Signature Date