Mask/Face Covering Assertion

I, [PARENT NAME], as a parent and/or legal guardian of [STUDENT NAME], a minor child, hereby exercise my right under the US. Constitution and laws of the State of Utah, to direct the upbringing and education of my minor child as follows:  

I hereby invoke our child’s exemption under the first amendment to the United States Constitution and the constitution of the State of Utah which authorizes parents as arbiters of children. 

We are exempting [STUDENT NAME] from wearing a respirator, mask or face covering of any kind.  

For the avoidance of doubt, my child is not allowed or permitted to wear a mask. 

Required Signature
I deny the release of my/my child’s directory information as indicated above.
                (Parent, Guardian or Eligible Student)
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