Hume Valley School
Early Pick Up Request Form for Students
Student Name: *
Student Sub-School & Class *
I would like to collect my child at 2:30pm from school.
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Please select the days of the week that you would like this to apply to:
2:30pm School Pick Up
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
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Parent Name & Mobile Number *
Parent Signature: By selecting the "YES" checkbox, you are signing this agreement electronically. *
Required
Please Note

This arrangement will continue to the end of Term 2. Please complete a new request form if you need to make any changes.
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