Dismissal Information
In order to ensure the safety of your child please inform us of how your child will arrive home. Please fill out one form per student.
Child's Name *
Grade *
Please check all that apply. *
1. Name
1. Relationship
2. Name
2. Relationship
3. Name
3. Relationship
4. Name
4. Relationship
If your child is to be picked up by someone other then the person(s) listed, a parent must call the school office before dismissal. The Child WILL NOT be released to anyone who is not on this form unless a parent calls in advance. This policy will be followed if a child is picked up early from school as well.
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