Early Pickup & Dismissal Change Form 2026
Please fill out this form to make a dismissal change. Form must be filled out by 2:30 pm on Monday- Thursday and by 12:30 pm on Fridays in order to guarantee that the message gets passed on on time.
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Camper #1 (First Name, Last Name, Bunk Number) *
Camper #2 (First Name, Last Name, Bunk Number)
Camper #3 (First Name, Last Name, Bunk Number)
What is your dismissal change? (for example: I am picking up Avi & Eli at 2:00 today and they will not be going home with their regular carpool, carpool #20 OR my son will be picked up at regular dismissal time by my husband and will not be going on the Clifton bus.) *
Please specify how your son usually gets home so we can inform the bus counselors or carpool staff that your son will not be going home that way today.  *
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