20 21 Arrival Dismissal Form
We want all students safe! Please fill out the following information so that we can help your child/children follow safe before and after school routines.  We know that sometimes special situations will change your family routines for before and after school.  Please fill out your plans for what will generally happen before and after school; if the general plan changes, please notify our office.  With this information, we can work together as school and families!  Thank you!
Note: One questionnaire per student

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Email *
Student Name (ex: Ben Smith) *
Student Grade Level *
Teachers Name
Before school my child typically arrives to school at: *
To get to school my child typically: *
If you selected "is dropped off by a daycare van" please indicate which daycare van:
Clear selection
When leaving school, my child typically: *
If you selected "is picked up by a daycare van" please indicate which daycare van:
Clear selection
Only persons listed here (outside of immediate family) shall be allowed to pick up my child from school: *
In the rare occasion of school being dismissed early because of an emergency situation, I want my child to: *
Do you have any other notes to add about your child(ren) arrival/dismissal plan?
Parent/Guardian Electronic Signature: *
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