Chemical/Supply Release Form


Student _______________________ Course ____________________

Teacher _______________________

I requested the following chemicals/supplies for my child's science project:


Cost: Chemical /Supply Name: Amount: Hazard:


$______ Total Cost


I have been informed of the proper handling procedures and special hazardous qualities of each of the above chemicals and supplies. I will supervise my child in their use and disposal. I will NOT hold the school authorities LIABLE in the event of injury caused by any of the above chemicals. I also agree to pick up the requested chemicals at school and transport them home in my personal vehicle.


Date_____________________ Signature (Parent/Guardian)___________________________________________________________



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