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5100 West Henrietta Road • PO Box 92912 • Rochester, New York 14692-9012 • p: 800 962-2660 • wardsci.com
K. Parent/Guardian Acknowledgment and Permission
• I have read and understand the safety guidelines, expectations, and procedures in this acknowledgment.
• I understand that my child is required to always follow all safety rules and practices during science
laboratory, classroom laboratory, and assigned home-lab activities.
• I have reviewed the laboratory rules and procedures with my child and will reinforce compliance
with these safety expectations.
• I understand that laboratory work involves inherent risks, including possible exposure to chemicals, heat,
glassware, electrical equipment, biological materials, sharp tools, and other laboratory apparatus.
• I give permission for my child to participate in approved laboratory activities and to use laboratory tools,
equipment, apparatus, and materials under teacher or authorized adult supervision after proper training.
• For assigned home-lab activities, I understand that adult supervision, safe setup, safe storage,
and emergency response at home are the responsibility of the parent/guardian or supervising adult.
Parent/Guardian Name:
Parent/Guardian Signature:
Date:
Parent/Guardian Email:
Parent/Guardian Phone:
L. Teacher/Instructor Acknowledgment
• I will review the science laboratory safety rules and procedures with students before their participation
in the laboratory.
• I will provide demonstrations, training, or competency checks where applicable before students use
apparatus, equipment, tools, machines, chemicals, biological materials, or other hazardous materials.
• I will inform students of required PPE, prohibited conduct, emergency procedures, and activity-
specific hazards.
Teacher/Instructor Name:
Teacher/Instructor Signature:
Date:
Parent/Guardian Safety Acknowledgment
(continued)
