OAK VALLEy MIDDLE SCHOOL
I have thoroughly read and will abide by the course expectations as outlined by Ms. Adery
Student Name (please print) ___________________________________________
Student Signature ___________________________________________
Student e-mail address ___________________________________________
I have thoroughly read and reviewed with my son/daughter the course expectations as outlined by Ms.
Adery. In addition, I have written any health problems that Ms. Adery should be aware.
Parent Name (please print) ____________________________________________
Parent Signature ____________________________________________
Parent e-mail address ____________________________________________
Cell phone ____________________________________________
Daytime phone ____________________________________________
Health Concerns: ____________________________________________________
Ms. Adery can be reached at email@example.com