FNF(EXHIBIT) - STUDENT RIGHTS AND RESPONSIBILITIES: INVESTIGATIONS AND SEARCHES

CRANDALL INDEPENDENT SCHOOL DISTRICTCRANDALL ISD STUDENT DRUG TESTING AUTHORIZATION

Student Name: __________________________________________ Date:

Parent/Guardian Name:

I acknowledge that I have received a copy of the Crandall ISD student drug testing policy for athletics and cheerleading programs, FNF(LOCAL). I recognize and understand that the student named above could be asked to provide a urine sample for drug analysis. I consent to any such testing conducted as part of the District mandatory/voluntary drug testing program.

Listed below are the prescription drugs and dosages my son or daughter takes on a regular/permanent basis.

My signature below indicates permission to the doctor(s) who has prescribed medication(s) for treatment of my current medical condition(s) to verify the circumstances and to discuss the effects of the medication(s) on the drug screening results.

My son or daughter does not take any prescription medication on a regular/permanent basis.

Student Signature: _______________________________________ Date:

Parent/Guardian Signature: ________________________________ Date:

Note: This authorization will be valid during the student's attendance at Crandall ISD.

Crandall ISD

FNF(EXHIBIT)-X

LDU-46-00

DATE ISSUED: 11/13/2000