Absence & Alternate Dismissal Form

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Please use this form for submitting information regarding full-day absences, late arrivals, early departures, mid-day appointments, or a change in dismissal plans from the ordinary.

"Alternate Dismissal Plan" is defined as a change from what your child typically does. For instance, if your child typically goes to The Club every day after school, we do not need you to complete the form UNLESS on a particular day your child will NOT be going to The Club. Any alternate dismissal plan information must be received by 2p on the day of plan implementation. Emergencies that arise after 2p (11a on Fridays) should be shared by calling the office directly at 812.558.0041. If you have questions about what constitutes an "Alternate Dismissal Plan," please give us a call.

PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD FOR WHOM THIS APPLIES, AND FOR EACH DATE OF ABSENCE.

Child LAST Name *

Child FIRST Name *

Child Classroom *

Please select the classroom associated with your child's LEAD TEACHER.

Parent/Guardian First & Last Name *

Parent/Guardian Preferred Contact Info To Use Regarding This Absence *

I need to speak to someone about this absence or plan change *

yes

Nature of Absence or Dismissal Change *

Full-Day Absence

Late Arrival

Early Departure

Mid-Day Leave & Return

Alternate Dismissal Plan

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