BERMUDIAN SPRINGS SCHOOL DISTRICT'S SAFE & DRUG FREE PLEDGE
The Safe and Drug-Free Schools (SDFSC) and the Communities Advisory Committee instituted a community program that gives you an opportunity to join your neighbors in a stand against the use of drugs and alcohol by our youth. The Pledge program asks parents to pledge, by completing this form, that all parties for school-age children in their homes will be chaperoned by parents and will be free of alcohol and other drugs. This list will be compiled and published on the district website. The list will be your guarantee that appropriate rules for children will be enforced in your home and of other parents on the list.
Sign in to Google to save your progress. Learn more
I pledge that all parties in my home for school-age children will be chaperoned by a parent or guardian,and will be free of alcohol and other drugs. *
Insert your full name here (Example: Jane Doe)
Street Address *
City, State, Zip *
My name can be put on the website *
STUDENT NAME *
LAST NAME, First Name (Example:  DOE, Jimmy)
School Attending *
Choose one
Student Name
LAST NAME, First Name (Example:  DOE, John)
School Attending
Choose one
Student Name
LAST NAME, First Name (Example:  DOE, Juanita)
School Attending
Choose one
Add more students here
Child Last Name, First Name/School (Example: DOE, Jean/BSHS, DOE, Jack/BSMS)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms