Texas School for the Blind and Visually Impaired Visitor Permission Form
A student’s parent/guardian/adult student/other person with legal authority, may give permission for designated visitors to visit with the student after school hours. The visitor may visit the student on campus or, with parental permission, take the student for an off-campus visit. Any authorized visitor must follow the same rules of conduct that apply to school staff members. The Superintendent or designee may restrict the visiting privilege of any visitor if the visitor has violated any school rules, commonly accepted social standards, or for any other reason having the visitor on campus is not in the interests of any student, employee or the School.


Due to the short instructional time during all of our programs, we ask families to consider the following before any visits are approved:
1. Visitors are allowed only during after-school hours.
2. The residential program is an important component of teaching the Expanded Core Curriculum (ECC) as well as a crucial opportunity for building friendships and bonding between students who may not regularly gain this experience.
3. If visits are unavoidable, they must be arranged and approved at least 24 hours in advance with our dorm manager so they are prepared to accommodate the request without disruption to the scheduled activities. Please be aware that your visit to the dorm often causes other students to experience homesickness because their families are unable to visit.
Student First Name *
Your answer
Student Last Name *
Your answer
Student Date of Birth *
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DD
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Visitor List
Please list the name and relationship of people who have permission to visit your student.

Please select Yes or No to indicate whether each visitor has permission to visit with your student on-campus, off-campus, overnight or to pick the student up on the last day. A student’s parent/guardian/adult student/other person with legal authority, may give permission for a person, other than the parent/guardian to pick up the student at the designated Weekends Home drop-off point. If you anticipate that you would like any person, other than the student’s parent/guardian, to pick up the student at the designated Weekends Home drop-off point, please include the person’s name and relationship above.


By signing below, you are authorizing the following list of visitors to have the specified privileges. Unless already specified on this form, parental permission will be obtained prior to any visitor wishing to take a student under 18 years of age off campus for any reason.
Visitor 1
1 ) Visitor Name
Your answer
1 ) Relationship
Your answer
1 ) On-Campus
1 ) Off-Campus
1 ) Overnight
1 ) Last Day Pick Up
Visitor 2
2 ) Visitor Name
Your answer
2 ) Relationship
Your answer
2 ) On-Campus
2 ) Off-Campus
2 ) Overnight
2 ) Last Day Pick Up
Visitor 3
3 ) Visitor Name
Your answer
3 ) Relationship
Your answer
3 ) On-Campus
3 ) Off-Campus
3 ) Overnight
3 ) Last Day Pick Up
Signed By *
Date Signed *
Please enter today's date
MM
/
DD
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YYYY
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