EHS Student Check Out Authorization and Information Form 2022-2023
The information below will be used in the event that your student needs to be checked out during the course of the school day.  
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Student's Last Name *
Student's First Name *
Student's School ID Number (Lunch Number) *
Student's Gender *
Student's Date of Birth *
Student's Cell Number
Student Resides with *
Primary Parent/Guardian Last Name *
Primary Parent/Guardian First Name *
Primary Parent/Guardian's Street Address *
Primary Parent/Guardian's City, State, Zip *
Primary Parent/Guardian's Cell Number
Primary Parent/Guardian's Work Number
Primary Parent/Guardian's Home Number
Primary Parent/Guardian's Email *
Secondary Parent/Guardian's Last Name
Secondary Parent/Guardian's First Name
Secondary Parent/Guardian's Street Address, City, State, Zip (If different from Primary Parent/Guardian's)
Secondary Parent/Guardian's Cell Number
Secondary Parent/Guardian's Work Number
Secondary Parent/Guardian's Home Number (If different from Primary Parent/Guardian's)
Secondary Parent/Guardian's Email
Please note that there will be no check outs after 2:45 pm on regular school days and 11:45 am on half days.  Students MAY NOT check out for lunch.  A government issued picture ID is REQUIRED in order to check out a student.  If unauthorized persons attempt to check out your student, they will be turned away.   *
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