Student Early Sign Out 2021-2022
Please complete this form before you pick up your child from school.  

Please Note:
-Once you arrive at school, knock on the office door to present your ID
-Student will be called out from class
-Keep in mind if you pick up your child during recess or lunch time, there may be a delay
Thank you!  

Mrs. Dina
562-229-7875

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Email *
Student First & Last Name *
Reason *
Teacher & Grade *
Approximate time you will be picking up your child. *Please note: Your child will not be called out from class until you arrive.  Keep in mind, if you pick up your child during recess or lunch time, there may be a delay. *
Time
:
Will you be signing out additional children? If so, please add the name of each child. *
First & Last Name of authorized person picking up student. (If other than parent/guardian)
*The person listed below will be picking up my child early from school and is listed as an emergency contact on the Aeries Parent Portal  (will be required to provide photo ID)
Parent First & Last Name *
*By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate.  You understand and agree to follow the return to school protocol if your child is exhibiting any of the above listed Covid-like symptoms.
A copy of your responses will be emailed to the address you provided.
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