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Emergency Dismissal
Please complete the form below in the event that we dismiss school early because of an emergency. Our phone lines become extremely busy during an emergency.We ask that you also discuss these plans with your student. Please complete one form per student. Please feel free to contact us with any questions or concerns.
Student's name
*
First Name
Last Name
Student's grade
*
Student's teacher or homeroom
In case we have an emergency dismissal, my student should
*
Walk directly home
Take their regularly scheduled bus (please select this only if your student rides the bus regularly)
Walk to an alternate address (specify below)
Other
You may not request a call in the event of an emergency dismissal.
Alternate address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsible adult at alternate address
First Name
Last Name
Contact number for alternate address
Please enter a valid phone number.
I have informed my child of these instructions and understand that it is my responsibility to notify the school should these instructions change throughout the school year.
*
Yes
Parent/Guardian's name
*
First Name
Last Name
Parent/Guardian's signature
*
Today's date
*
-
Month
-
Day
Year
Date Picker Icon
Submit
Should be Empty: