HTML Preview Minor Employee Drug Test Consent Form page number 1.
PRE-EMPLOYMENT SCREENING – RECREATION DEPARTMENT
Drug and Alcohol Testing Consent Form for Minors
Draper City requires final candidates to pass a drug test as a prerequisite to obtaining employment. (Other testing may take
place depending on the position sought). Candidates and employees under the age of 18 must have a notarized consent
and release form signed by a parent or legal guardian prior to testing.
By signing this form and having it notarized, you are allowing your child to provide a urine specimen for the purpose of
screening for the presence of drugs and alcohol. This consent shall be valid for the candidate’s pre-employment drug test
and if hired, for his/her term of employment with the City or until the candidate reaches the age of 18, whichever may come
first.
I, _____________________________________________, am the parent or legal guardian of _______________________
______________________________________________, who has applied for employment with Draper City. I have read
the explanation set forth above on the City’s drug testing policy. I hereby consent for testing to be done on my child in
accordance with the City Policy and I authorize the release of the results of this test to Draper City.
____________________________________________ ____________________________________________________
Signature of Parent or Legal Guardian Date
STATE OF UTAH
§
COUNTY OF SALT LAKE
On the _________ day of __________________________, _________, personally appeared before me,
________________________________________________, who did say that he or she executed the foregoing document.
____________________________________________________
NOTARY PUBLIC
My Commission Expires: Residing at:
_____________________ ____________________________________________________