Release of School Records (Entrega de registros escolares)

Release of School Records to Hunting Park Christian Academy
Date*

MonthDayYear
Previous School Name*
Street Address*

Street Address

CityState

Postal / Zip Code
Phone*
Format: (000) 000-0000.
Fax*
Student*

First NameLast Name
Grade*
Birth Date*

MonthDayYear
I hereby give permission to the above named school to release all records including academic, medical, and confidential, on the above named student.

Por la presente doy autorización a la escuela arriba para la divulación de los registros sobre el estudiante arriba.
Signature of Parent/Legal Guardian*
Email*
example@example.com
Should be Empty:

Release of School Records to Hunting Park Christian Academy