Encounter Week Time Away Form
If your student needs to leave early from camp please fill out the following information. Students that leave before we get on the bus to come home will not be aloud to return to camp after leaving.
Student's Name
*
First Name
Last Name
Student's Current Grade
*
7
8
9
10
11
12
Gender
*
M
F
Reason for leaving early:
*
Student will be picked up by:
*
First Name
Last Name
Phone number for person picking student up:
*
Please enter a valid phone number.
Relationship to student:
*
Day your student will be leaving:
*
Monday, June 7
Tuesday, June 8
Wednesday, June 9
Thursday, June 10
Friday, June 11
Time your student will be leaving:
*
Hour Minutes
AM
PM
AM/PM Option
Other notes we need to know:
*
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Email
example@example.com
Submit
Name
First Name
Last Name
Should be Empty: