2024-2025 Student Handbook Acknowledgment and Consent to Treat
 

This form serves as an acknowledgment that you have read and understand the material in the 2024-2025 Student Handbook located on the Pinkerton Academy website.

It is important that everyone is familiar with the expectations of Pinkerton students and has a working knowledge of the rules and regulations by which the Academy is governed, including our updated rules and regulations for the upcoming school year.

It is also important that students take advantage of the many opportunities at Pinkerton including extracurricular activities, the cafeteria and lunch programs, and the school’s health services. These are all outlined in the handbook. The Student Handbook also contains valuable information about other aspects of how Pinkerton Academy operates including our vision and mission, and the appropriate channels for parents to address conduct, academic, faculty, and athletic issues.

Failure to return this form may result in ineligibility to participate in school activities and/or administrative action.

Additionally, New Hampshire law requires that parents/legal guardians provide written consent allowing for medical and dental treatment of students in a school setting.  This may include, but is not limited to hearing/vision screenings, treatment of minor or major illness and injury, basic First-Aid. Nursing does reserve the right to call 911 in the event of a medical emergency. (Pinkerton Academy is not responsible for costs incurred in the event EMS determines transport is necessary). Examples of conditions treated in a school setting may include but is not limited to first aid for sprains, strains, fractures, splinter removal, wound/laceration care, burn care, allergic reactions, asthma attacks, diabetic emergencies, GI illness, and headaches. This form serves as a consent to treat as well.

If you do not agree to the consent to provide treatment, you must contact the Associate Head Of School’s office to acknowledge the Student Handbook separately. Failure to do so may prohibit participation in extracurricular activities.

I, the undersigned, acknowledge that the 2024-2025 Pinkerton Academy Student Handbook is available on the Pinkerton Academy website. I affirm that I have reviewed all of the materials, am aware of their content, and will abide by Pinkerton Academy’s policies and procedures. By signing this document acknowledging the Student Handbook, I also authorize the school nursing staff to assist and provide treatment and care to all students in my legal care as needed. I agree that we will not hold liable any member of the school staff whose duty it is to treat and care for our students. Signing below indicates both the acknowledgment of the Student Handbook and gives consent for treatment by Health Services.
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