Post Event Release Form
Release of Student to Parent/Guardian After Field Trip or Activity Form 3204-2. To be completed by the Parent/Guardian ONLY.

The parent/guardian must check out their student in person. Students will not be released until the end of our itinerary just before we depart for Buchanan.
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I, the parent/guardian of the student listed below, request that my student, a student at Buchanan High School, be released to my custody after the listed trip/activity on the date below rather than returning to school in the transportation provided by Clovis Unified School District (District).
Student First Name *
Student Last Name *
Location of Event or Event Name *
Date of Event *
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/
DD
/
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Parent/Guardian to whom the student is to be released. Please be prepared to show I.D.
This must be the parent/guardian of the student. Students will not be released to anyone but their parent/guardian.
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Contact Phone Number *
Parent/Guardian Email *
Waiver of Claims: *
I agree that once my son/daughter is released to my custody, I assume full responsibility for his/her health, safety and welfare and as provided for in California Education Code Section 35330. I agree to waive all claims against the District and hold the District, its officers, agents and employees, harmless from any and all liability or claims, which may arise out of or in connection with my child’s participation in this activity. This waiver shall not apply to any occurrences which may arise solely out of the negligence of the District, its employees or agents.
Required
Parent/Guardian Typed Approval Signature *
Please type your full name.
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