2018-2019 Hastings Student Dismissal and Permission Form
This form serves as the entry portal for our 2018-2019 student dismissal information. This was previously completed via paper that was sent home in our back to school mailing in August. By completing this online, we can gather your child/(ren)'s information faster and save paper.

You can enter your child's information once you receive the summer mailing identifying their homeroom teacher. Please finish entries by 10pm on August 24th. If you make an entry and then change something before the 24th, we will take the NEWEST entry you've made.

Thank you for helping our staff by completing this form for EACH CHILD that you have attending Maria Hastings Elementary School.


Student First Name: *
Your answer
Student Last Name: *
Your answer
Homeroom Teacher *
Grade: *
Daily Dismissal Information: *
Please indicate each day's routine.
Bus
Hayden Bus
Walk
Car
Extended Day
Monday
Tuesday
Wednesday
Thursday
Friday
My child may be dismissed to the following adults other than parents/guardians:
Just list first and last names of each adult, separated by commas, ie: John Smith, Mary Brown, etc. For a more detailed note beyond just names, please submit that to the teacher.
Your answer
Video/Photography/Quoted in School, PTO or Community Newspaper *
I give permission for my child to be photographed/videotaped and quoted for school purposes to inform the community about school activities via the School, PTO or Community Newspaper. Please indicate your permission (Yes or No).
Video/Photography/Quoted on School Website/Social Media *
I give permission for my child to be photographed/videotaped and quoted for school purposes to inform the community about school activities via: School Website/Social Media (Photos or student work only. Names will NOT be used.) Please indicate your permission (Yes or No).
Video/Photography/Quoted Displayed in School-For Parents *
I give my permission for my child to be photographed/videotaped and/or quoted for school activities via photographs and/or videotapes for display in school or for parents. NOTE: The law provides that students may be photographed during special events open to the public. Please indicate your permission (Yes or No).
Medical Information Sharing Permission *
I give permission to the school nurse to share information relevant to my child(ren)'s health condition with appropriate school personnel when needed to meet my child(ren)'s health and safety needs, or for emergency medical personnel and receiving hospital, including persons to contact information, in the event that my child(ren) requires emergency medical treatment. I give permission to exchange information with my child's primary care physician for the purpose of referral, diagnosis and treatment.
Biking to School (Grades 3-5)
I give permission for my child (grade 3-5 only) to ride his/her bike to and from school unaccompanied. I understand that it is my responsibility to help my child find a safe route home, to teach my child bicycle safety rules, ensure that my child is wearing a helmet, and is responsible for locking his/her bike on school premises. Note: Skates, rollerblades, skateboards are not permitted on school property.
Electronic Signature *
Your electronic signature below indicates that you give your permission for all items checked yes above. Type Electronic Signature In Box
Your answer
Date *
MM
/
DD
/
YYYY
Submit
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