Kellam Early Release Request

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,. . Requests AFTER 7:20 am must be called in by a Parent/Guardian to a School Administrator for authorization.

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

Phone verification to parents will be conducted prior to release.

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

Student Name: *
FIRST and LAST Name
Student ID Number
Date of Early Release *
MM
/
DD
/
YYYY
Time of Early Release *
Time
:
Reason *
Returning later today? *
Parent/Guardian Phone Number for Verification *
If other than parent, NAME of person picking up student.
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.
Parent Signature: Full Legal Name (First and Last) *
Parent Signature - Your typed name is an acknowledgment of signature needed for student release
Submit
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