2024 MMSS Pick Up Authorization

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Complete the following form in order to authorize your child's temporary departure from campus. Please note that in order for your student to be released, the designee must show photo ID.

This form must be completed each time your child will be picked up. Each submission MUST include the date and time of pick up and return.

Email *

Your Name: *

Your Child's Name: *

Name of the individual authorized to pick up your child: *

Date of pick up *

YYYY

Time of pick up *

Time

Date of return *

YYYY

Time of return *

Time

Comments:

By providing an electronic signature below, I authorize MMSS staff to release my child to the individual listed above. *

Send me a copy of my responses.

Submit

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