Correia Student Release Form
Please complete this form prior to pickup to help expedite the checkout process.
Adult picking up student must be on the contact list and show proof of ID.
Email *
Last Name (Student) *
First Name (Student) *
Grade *
Time Leaving *
Time
:
Date *
MM
/
DD
/
YYYY
Reason *
Digital Signature (By entering my name, I attest to being the parent or legal guardian) *
A copy of your responses will be emailed to the address you provided.
Submit
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