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3415F.2 (Rev. 03/10/03) VOLUNTARY PARENT DESIGNATED ADULT NOTICE OF INTENT (School Employee) Washington State requires public school districts to address the medical needs of students with diabetes.
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How to Fill Out Voluntary Parent Designated Adult-Non-School Employee Doc:

01
Begin by clearly stating the purpose of the document at the top, for example: "Voluntary Parent Designated Adult-Non-School Employee Doc."
02
Include your personal information, such as your name, address, and contact details. It is important to provide accurate and up-to-date information.
03
Indicate the name of the school or organization where the document will be used. This helps identify the specific context for which the document is intended.
04
Specify the name of the parent or legal guardian who is designating the adult-non-school employee. Provide their full name and contact information.
05
Clearly state the name of the designated adult-non-school employee. Include their relationship to the child and contact information.
06
Indicate the specific activities or responsibilities that the designated adult-non-school employee will fulfill. This could include tasks such as picking up the child from school, supervising them during extracurricular activities, or providing any necessary care.
07
Mention any relevant details, such as specific dates and times, if applicable. This helps define the scope and duration of the designated adult-non-school employee's responsibilities.
08
Make sure both the parent or legal guardian and the designated adult-non-school employee sign and date the document. This ensures their consent and agreement to fulfill the designated role.
09
Keep a copy of the completed document for your records and provide a copy to the school or organization where it is required.

Who Needs Voluntary Parent Designated Adult-Non-School Employee Doc:

01
Parents or legal guardians who wish to designate a responsible adult to fulfill certain duties or responsibilities related to their child outside of school hours.
02
Schools or organizations that require documentation from parents or legal guardians when designating an adult-non-school employee for specific tasks or activities involving children.
03
Children who may require supervision, care, or assistance from an adult who is not a school employee during certain periods, such as after school or during extracurricular events.
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Voluntary Parent Designated Adult-Non-School Employee Document is a form that allows parents to designate a trusted adult who is not employed by the school to pick up their child from school.
Parents or legal guardians are required to fill out and file the Voluntary Parent Designated Adult-Non-School Employee Document.
The form typically requires the parent or legal guardian to provide their contact information, the contact information of the designated adult, and any relevant authorization details.
The purpose of the form is to ensure that the school releases the child only to authorized individuals, thereby enhancing the safety and security of the child.
The form typically requires the names, contact information, and relationship to the child of the parent or legal guardian, as well as the designated adult.
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