StudentEarlyRelease

THIS FORM IS TO BE FILLED OUT BY A PARENT/GUARDIAN

From time to time, students have valid reasons to leave school grounds before the end of the regular school day. In order to safeguard their wellbeing, a strict protocol is in place. To start the process, a parent or guardian must request an early release through this form at least 1 hour prior to the time of dismissal, with the option of submitting it up to five days in advance.

Students may be dismissed early only until 3 PM on Monday, Tuesday, and Thursday and 2 PM on Wednesday and Friday.

The school will call you to verify the form for a final verbal confirmation before the student is dismissed.

Please note: authorization must be given separately for each child requiring early dismissal. This is necessary to ensure each student's request is accurate and accessible.

Which division is the student in?*

Reason for Early Dismissal:*

Please select the student's homeroom teacher

Student First Name*

Student Last Name*

Grade:*

Student E-mail*

firstname_lastname@mynbps.org

Student Cell*

Area CodePhone Number

Parent Full Name*

First NameLast Name

Parent Cell*

Area CodePhone Number

Parent E-mail*

INFORMATION REGARDING EARLY DISMISSAL

Please provide description for Early Dismissal:

What is the date of the early dismissal?*

MonthDayYear

What is the time of early dismissal? (M,T,TH LAST DISMISAL TIME IS 3:00. W&F LAST DISMISSAL TIME IS 2:00)*

:HourMinutesAM/PM Option

Will the student be returning to school?*

YesNo

Estimated time student will return?*

:HourMinutesAM/PM Option

Student Drivers: Students who drive their own vehicles and need early dismissal due to an off-campus commitment will be granted dismissal passes contingent upon the consent described above. Before departure, the student must receive a pass from the Dean’s Office. Should a student leave campus without signing out and receiving their pass, they will not be excused for the day and it will be treated as a skip. All drivers are expected to stop at the security gate and hand the guard the pass.

High School Students: Non-driving High School students will be granted dismissal passes contingent upon the consent described above. Before departure, the student must receive a pass from the Dean’s Office. The parent, guardian, or individual authorized for pickup may wait for the student in the car at a pre-arranged location for the student to meet them at. Should a student leave campus without signing out and receiving their pass, they will not be excused for the day and it will be treated as a skip. All drivers are expected to stop at the security gate and hand the guard the pass.

Middle School Students: Middle School students should report to the MS Office at the designated time. The parent, guardian, or individual authorized for pickup may wait for the student in the car at a pre-arranged location for the student to meet them at or come in to the MS Office. They will be granted a dismissal slip to show to security upon leaving the campus and may be asked to produce a valid ID.

Lower School Students: Lower School students will be called to the LS Office at the designated time. The parent, guardian, or individual authorized above for pickup must come to the LS Office to collect the student in person. They will also be granted a dismissal slip to show to security upon leaving the campus and may be asked to produce a valid ID.

AUTHORIZATION

I, parent/legal guardian of the above-named student at North Broward Preparatory School do hereby authorize permission for my child to dismiss early from school at the date and time listed above. I further acknowledge and authorize the manner in which my child will be dismissed and/or accompanied off campus by the person listed.

By submitting this form and signing below, I attest to be the parent or guardian of the above-named student and am granting permission for my child to leave school early at the time and date listed on this form and with the person listed above. Further, I agree to all the terms of this form.

Please select one of the following that directly applies to your student:*

Please provide the name and relationship of the person you are authorizing to pick up your child.*

First Name Last NameRelationship

Parent Signature*

Parent Name (Typed)*

First NameLast Name

High School students report to the Dean's office to receive their dismissal pass and sign-out.

Middle School students report to the middle school office to receive their dismissal pass and sign-out.

Parents or authorized pick up persons should remain in their vehicle and wait for the student to meet you at the car after signing out.

This form should not be used for students who are feeling unwell. If a student is sick, please direct them to the health office for proper dismissal. Thank You.