River Vale,
Family Life Education Exclusionary Form
The
purpose of this form is to insure compliance with the family life education
requirements which indicate that procedures be established for any student
whose parent or guardian presents to the school principal a signed statement
that any part of the instruction in family life education is in conflict with
his/her conscience or sincerely held moral or religious beliefs. In such cases, the student will be excused
from that portion of any course. [NJSA 18A:35-365 et seq.]
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Date
of Request ___________________________
Student’s
I
request that my child be excused from participating in the following portion(s)
of the family life education program because it is in conflict with my
conscience or sincerely held moral or religious beliefs.
Topic
(be as specific as possible):
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Objections
(list all that apply):
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
This
form will be forwarded to the appropriate teacher.
________________________________________
Signature of Parent/Guardian
FRA:eef