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STUDENT PICKUP FORM
We will begin dismissing car riders promptly at
3:25 PM
.
Each family is provided 1 car tag (if you need an extra, please request one from Mrs. Burkhart). It is your responsibility to maintain these tags and have them visible when picking up your student.
Parents of younger children: In an effort to expedite dismissal, please help us by teaching your child to buckle themselves into their car seats independently. The disruption to the flow of traffic when parents must get out of their vehicles to secure children in car seats delays our dismissal unnecessarily. If your child is unable to independently buckle themselves into their carseats, please pull into a spot out of the flow of traffic.
To assist us in ensuring we safely & efficiently dismiss our entire student body, we ask that all car rider requests be submitted prior to 2:00 PM.
If your child will be a car rider every day or every Wednesday, please submit one note for the year.
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Email
*
Your email
STUDENT NAME
*
Your answer
Person who will be picking up the child.
*
Your answer
TEACHER NAME
*
Choose
MULDER
1- DOUTS
1- EBY
2 - SCHUCK
2- BOHANNON
3- HARTMAN
3- RINALDI
4- SHOWALTER
4- DAVIS
5- EBY
5- SCHUMACHER
6- FAFEL
6- POLASKI
KIRKLEY
PICK UP TIME
*
Time
:
AM
PM
Date for pick up:
*
MM
/
DD
/
YYYY
Additional Notes
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A copy of your responses will be emailed to the address you provided.
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