Kellam Early Release Request

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Request for Early Release must by submitted no later than 7:20 am day of requested date, but no earlier than 3:30 pm the day before the requested early release day. NO ADVANCED REQUEST PLEASE.

Submissions AFTER 7:20 am will not receive a phone call for verification, therefore Parent/Guardian will need to personally come to the Security Desk with ID for verification. For Students driving themselves, Parent/Guardian must call Main Office to request authorization of early release by School Administrator.

Students will be released to only those listed on Student's Emergency Contact List.

Phone verification to parents will be conducted prior to release for those submitting this form BEFORE 7:20 am, all others must come into the school when picking up their student.

Student's must SIGN OUT at the front security desk before leaving the school building.

Due to COVID protocols, all students requesting to be released early, due to illness, must be screened through the school clinic prior to release. For any questions, please contact the School Nurse, Karen Ware at 648-5107 or Beth Ford at 648-5108

Student Name: *

FIRST and LAST Name of Student

Student ID Number

Date of Early Release - Date must be today or tomorrow: no advance requests please *

YYYY

Time of Early Release *

Time

Reason *

Returning later today? *

Yes

If other than parent, NAME of person picking up student: Please Indicate if student is Driving themselves

Please specify Relationship and Name - Only those listed on emergency pick up list will be authorized to pick up student. Please indicate if student is driving themselves by indicating " Driving "

Parent Phone Number for Verification *

Parent Signature: Full Legal Name (First and Last) *

Parent Signature - Your typed name is an acknowledgment of signature needed for student release

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