School Name and Address:

Date: ___________________________

RE: LAW ENFORCEMENT INTERACTION WITH MY CHILD

To Whom It May Concern:

Please consider this a notification to the school that I reserve my rights as a parent or guardian of my
child(ren) at your school with regard to their interaction with law enforcement.

Under no circumstances is my child(ren) to be interviewed or questioned by any law enforcement at

your school or to be taken from your school premises for that purpose without my express permission.
In the event of any questioning by law enforcement, my attorney must be present in the room with
my child during the interview.

Furthermore, I am to be notified immediately if law enforcement requests or attempts to question or

engage in any way with my child. A school representative can reach me at:

Home: ______________________________ Work: _______________________________

Mobile: ______________________________ Email: _______________________________

Other: _______________________________ Other: _______________________________

For the record, I am the parent or guardian of the student(s) listed below:
Student(s) Name(s) Age Grade

Best regards,

_________________________ _________________________