This form allows your student to leave campus during lunch. The District has, for many years, allowed middle and high school students the option of leaving campus to go into town for lunch. The District’s legal counsel, in reviewing policies and practices, advises that the District that must receive written parental consent in order to permit a student to leave campus during his/her lunch period.  If you have more than one child, you must fill out and return a separate form for each child.

PLEASE NOTE THAT SIXTH GRADERS WILL ONLY BE ALLOWED OFF CAMPUS AT LUNCH ON OCCASION. NOTIFICATION OF THESE DATES WILL BE COMMUNICATED TO FAMILIES VIA EMAIL. Otherwise, it is expected that 6th graders will eat in our lunchroom each day. This form also allows for families to give permission for their children to walk off campus with their teacher for occasional trips into town. 

The Consent Agreement  authorizes the release of your child from campus during his/her lunch period. Please note that if the District does not receive the Consent Agreement, your child will not be allowed to leave campus during his/her lunch period. Additionally, please be reminded that while staff is walking in town, your child will not be directly supervised while off campus for lunch.  While your child is off campus during his/her lunch break, he/she is expected to abide by the District’s Code of Conduct, otherwise the privilege is revocable by the school for any reason.  

My signature below indicates that I am the Parent/Guardian of the student named below.  By signing below I hereby grant permission for my child to leave the Bronxville campus during his/her lunch period in order to purchase lunch off campus. I understand that the Bronxville District provides the option of an on-campus lunch period for my child, however, I acknowledge that I am waiving that option and allowing my child to leave campus without any supervision from District employees on any given school day.

In consideration for allowing my child to leave campus during his/her lunch period, I hereby release the District, the Board of Education of the Bronxville Union Free School District (“Board”), its members, individually and in their official capacities, the Superintendent of Schools, individually and in his official capacity, or any of the District’s employees, agents or independent contractors, from any liability, claim, suit or expense including, but not limited to negligence, for any injury or harm which may result from my child leaving campus during his/her lunch period.

Neither I nor anyone acting on my behalf will make a claim against the District, the Board, individually and in their official capacities, the Superintendent of Schools, individual and in his/her official capacity, or any of the District’s employees, agents or independent contractors, as a result of any loss, injury, or damage suffered by me (or my student) as a result of allowing my student to leave campus during his/her lunch period. This release includes any losses caused or alleged to be caused, in whole or in part, by the negligence of the District and/or its employee, agents or independent contractors to the fullest extent allowed by law.

I have carefully read, understand and voluntarily sign this Agreement. If you have any questions about these policies, please do not hesitate to contact the Principal directly.