Request to Leave Campus with Parent/Guardian
Use this form to submit a request to IMSA's president, Dr. Evan Glazer, to check your child out from campus for an overnight stay between February 1-16, 2022. You do not need to fill out the form for a trip on the same day. You do not need to fill out this form if you are missing class on February 17 due to inclement weather or plan to be absent following February 17.
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Name of parent as primary point of contact
Include parent email
Include your preferred phone number
We are trying to limit overnight stays because a vast majority of our COVID cases come from home environments, including families that are vaccinated. Explain why your check-out must require an overnight stay and not a same day experience.
Describe the specific dates and times you will be off campus
Explain the health precautions you will take while off campus to ensure your child will not be at risk to COVID
A negative COVID rapid test result is required to be taken on the same day of your return, except for those who are medically cleared. The test should be taken at a clinic so you have an official record. Name the date and town you plan to get your rapid test. If you think you have a medical exemption, enter "check with the nurse." If you are not sure if you are medically cleared, enter "not sure" followed by the location you plan to take the test if necessary.
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