2024-2025 STUDENT EARLY DISMISSAL

2024-2025 STUDENT EARLY DISMISSAL
Dear Parent/Guardian,

In the event that you need to pick your student up prior to the end of the school day for an appointment or due to illness, please complete the form below. We appreciate a minimum of a half an hour notice to insure promptness. We will arrange to have your student waiting for you in the lobby at the designated time. When you arrive, the Lobby Receptionist will release your child/ren. It is not necessary to call the school office, this form goes directly to the office and the lobby receptionist emails.

If your child is leaving early due to an illness, please pull up to the Orchard Street doors and call the office when you arrive. We will walk your child out to you.
Date*

MonthDayYear
Date
Name of student being released:*

First NameLast Name
Time of student's departure:*

:HourMinutesAM/PM Option
Will your student be returning to school:*

YesNo
If your student is returning, what time will they return:
Reason for early dismissal:*

Doctor AppointmentDentist AppointmentOrthodontist AppointmentSportVacationSickOther
Name of Parent/Guardian picking up the student:*

First NameLast Name
Contact number of Parent/Guardian picking up the student:*

Area CodePhone Number
Parent/Guardian Signature*

Clear
Homeroom Teacher*

First NameLast Name
Additional Information/Notes
Should be Empty: