Correia Student Release Form

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Correia Student Release Form

Please complete this form prior to pickup to help expedite the checkout process.
Adult picking up student must be on the contact list and show proof of ID.

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* Indicates required question

Email *

Your email

Last Name (Student) *

Your answer

First Name (Student) *

Your answer

Grade *

7th

8th

Time Leaving *

Time

:

AM

PM

Date *

MM

/

DD

/

YYYY

Reason *

Your answer

Digital Signature (By entering my name, I attest to being the parent or legal guardian) *

Your answer

A copy of your responses will be emailed to the address you provided.

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