I, , the legal guardian of , confirm that my request for administration of medication at school for my child is necessary, in that the medication be given during school hours. I HEREBY RELEASE MOUNTAIN CHRISTIAN SCHOOL, its officers, directors, administrators, and employees, of any liability for any and all claims whatsoever that I might have or that I might bring on behalf of my child, in connection with my current “Request for Administration of Medication at School”. I also hereby give permission for this information to be used by the School Based Team (principal, classroom teacher, learning assistant teacher, and appropriate student support personnel).