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Out of State Le Jardin Academy Travel Declaration
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* Indicates required question
Email
*
Your email
Student/Employee Last Name
*
Your answer
Student/Employee First Name(s) - include multiple kids if needed
*
Your answer
Parent Contact Number/Employee Number
*
Your answer
Student Grade
*
PK
JK
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Employee
Other:
Required
Date of Departure
*
MM
/
DD
/
YYYY
Date of Return
*
MM
/
DD
/
YYYY
COVID Test Date (upon arrival)
*
MM
/
DD
/
YYYY
COVID Test Date: 5 days upon returning
*
MM
/
DD
/
YYYY
COVID Response Update as of August 22, 2022
*
I have read the most current COVID Response Update and I am aware of the Return-to-School home testing requirements
Required
A copy of your responses will be emailed to the address you provided.
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