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.
* Required
Student Name:
*
FIRST and LAST Name
Your answer
Student ID Number
Your answer
Date of Early Release
*
MM
/
DD
/
YYYY
Time of Early Release
*
Time
:
AM
PM
Reason
*
Choose
DR Appt
ILL
Funeral
Religious Holiday
Going Home to Attend Class Virtually
Early Release before Study Block
Other
Returning later today?
*
Yes
No
Parent/Guardian Phone Number for Verification
*
Your answer
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.
Your answer
Parent Signature: Full Legal Name (First and Last)
*
Parent Signature - Your typed name is an acknowledgment of signature needed for student release
Your answer
Submit
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