Kellam Early Release Request

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To receive verification, requests for Early Release must by submitted no later than 7:20 am day of requested date, but no earlier than 3:30 pm the day before the requested early release day. Please No ADVANCED REQUEST for future dates.

Submissions AFTER 7:20 am will not receive a phone call for verification, therefore Parent/Guardian will need to personally come to the Security Desk with ID for verification. For Students driving themselves, Parent/Guardian must call Main Office to verbally authorize their student for early release.

Students will be released to only those listed on Student's Emergency Contact List.

Student's must SIGN OUT at the front security desk before leaving the school building.

Student Name: *

FIRST and LAST Name of Student

Student ID Number *

Date of Early Release - Date must be today or tomorrow: no advance requests for future dates please *

YYYY

Time of Early Release *

Time

Reason *

Returning to classes later today? *

Yes

If other than parent, NAME of person picking up student: Please Indicate if student is Driving themselves

Please specify Relationship and Name if someone other than parent is picking up - Only those listed on emergency pick up list will be authorized to pick up student. Please indicate if student is driving themselves by typing " Driving "

Parent Phone Number for Verification *

Parent Signature: Full Legal Name (First and Last) *

Parent Signature - Your typed name is an acknowledgment of signature needed for request of student release

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