Parental Release Form
For your child's safety, please complete the following by providing the name(s), phone number(s), and relationship to the child of individuals to whom you give your consent for your child's release from school. These names would be in addition to the emergency contacts already provided.   If at any time you need to make a change, please put it in writing and we will make the necessary changes.  
Student's Name and Room Number *
Adult Name, Phone Number and Relationship to the Child *
Adult Name, Phone Number and Relationship to the Child *
Adult Name, Phone Number and Relationship to the Child *
Please type your name and date as your approval. *
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