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Authorization of Release of Records

Registration Deadline 06/21/2021

I hereby authorize the release of any medical, psychological, academic or other confidential records (such as an IEP), which may be protected by the Family Educational Right to Privacy Act (FERPA) or the Health Insurance Portability and Accountability Act (HIPAA) of 1996, concerning my child referenced below, to the Lansingburgh Central School District.

Authorization of Release of Records - August 01, 2020 to June 01, 2021
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