2023-2024 LIS Permanent Pickup
I understand the procedure to have my children placed on the LIS Permanent Pickup list is as follows: 
1) Complete & submit the following form PRIOR to the first day of school. 
2) Agree to be in line in front of the building by 3:15pm. 
3) Agree to have the correct identification in my car and visible to the Permanent Pickup Staff. 
4) Agree that if you do not have the sign, you or your designated person will go to the LIS office and sign out your child(ren). 
5) Agree that if you have children at both Bascom & LIS, that you will pick up you LIS child FIRST, and then proceed to Bascom. 

My submission of this form means: 
I understand that my child will not be permitted on the bus. 
Myself & my designated person will be in front of the building by 3:15pm. 
If an emergency arises and I cannot pick up my child, I will notify the office by 2:00pm so appropriate accommodations can be made. 

Please list SEVERAL names and numbers in the form below
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LIS Student Name(s):  *
Parent/Guardian (Authorized to pick up):  *
Parent/Guardian Phone Number:  *
Person 1 Authorized to pick my child up from Permanent Pickup:  *
Person 1 Phone Number: *
Person 2 Authorized to pick my child up from Permanent Pickup:  *
Person 2 Phone Number: *
Person 3 Authorized to pick my child up from Permanent Pickup: 
Person 3 Phone Number: 
Person 4 Authorized to pick my child up from Permanent Pickup: 
Person 4 Phone Number: 
How many car tags are you requesting:  *
List any person(s) that are restricted legally from picking your child(ren) up from school. (Appropriate court documents MUST be on file with this school for this to be effective): 
Please type your name & date indicating that you give permission for the above persons to pick up your children after school. If this list changes, you agree to notify the school immediately.  *
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