Summer 2024 Approved Adult Check Outs
Thank you for requesting a checkout for your participant. Only parents or legal guardians may complete this form. 

Complete one form per checkout prior to the start of the program. Checkouts should be a maximum of three (3) hours. 

All requests must be approved by Stanford Pre-Collegiate Studies. You will receive a response via email informing you if we have approved your request.

if there is a family emergency or extenuating circumstance that would require a participant to temporarily leave the program without prior approval, do not submit this form. Call 650-285-9891 to notify Stanford Pre-Collegiate Studies staff and them staff when the participant will be leaving and returning to the program.

 Direct any non-emergency questions to spcs-residential@stanford.edu. 

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Parent/Legal Guardian Full Name *
Parent/Legal Guardian Email Address *
Parent/Legal Guardian Cell Phone Number *
Please use XXX-XXX-XXXX format. 
Participant Full Name *
Participant Cell Phone Number *
Please use XXX-XXX-XXXX format. 
Participant's Program *
Date participant will be checked out *
MM
/
DD
/
YYYY
Time participant will be checked out of program *
Time
:
Time participant will return to program *
Time
:
Full name of the person checking participant out *
This person must be listed as "Approved Adult" on your participant's CampDoc forms, over the age of 18, and able to present a valid photo ID to staff. If the person does not meet one or more of the criteria, staff will not be able to approve the checkout. 
Where will the participant be going while they are checked out? *
Examples: They will be going to a family friend's house in Mountain View; they will be having dinner with family in Downtown Palo Alto
Approved Adult Cell Phone Number *
Please use XXX-XXX-XXXX format. 
All requests must be approved by Stanford Pre-Collegiate Studies. Requests may be denied if approved adult is not listed in CampDoc, the individual is under the age of 18, they do not have a valid photo ID, the duration of the checkout is too long, or the request conflicts with scheduled program activities.

You will receive a response via email informing you if we have approved your request. *
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