Off-Campus Authorization 23-24

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Parent/Guardian of the student must fill out this form using a non-student email account

Off Campus privileges are reserved for only Juniors and Seniors for the 23/24 school year.

IF CHOOSING TO GRANT OFF-CAMPUS PERMISSION, PARENTS/GUARDIANS ACCEPT RESPONSIBILITY FOR STUDENT’S WHEREABOUTS, CONDUCT, AND WELFARE WHILE AWAY FROM CAMPUS. ANY TRANSPORTATION USED BY STUDENTS DURING THIS RELEASE WILL BE BY PRIVATE CAR AND, SHOULD AN ACCIDENT OCCUR, THE PARENTS/GUARDIANS WILL NOT ATTEMPT TO HOLD THE BOARD OF EDUCATION OR ANY OF ITS EMPLOYEES RESPONSIBLE.

In order to grant your student this privilege, you must initial and acknowledge each of the following statements. Your initials will indicate you have read and understand that statement. Typing your name and date at the end of this form will also constitute your signature and subsequent permission for off-campus privileges to be allowed for your Junior /Senior student. Lastly, this form will collect the respondents email address and it must match a parent or guardian email that is listed in PowerSchool for that student. If you have multiple students you must complete the form for each student.

Email *

Student's Last Name *

Student's First Name *

Student's ID *

Current Grade Level *

Junior

Senior

Please read and initial after each of the following statements indicating your acknowledgment.

Permission to leave campus during lunch is a PRIVILEGE that may be SUSPENDED or REVOKED by an administrator for any of the following reasons:

A repetition of tardiness to the class immediately following the lunch period *

Any truancy or suspension *

Failure to wear ID *

Using exits other than Door 1 to enter OR Door 10 to leave the building *

Any misconduct of the student or any other violation of the student handbook *

Going off campus any period other than lunch (unless approved for a Blended class) *

Not returning to classes after lunch. *

Leaving the building but not leaving campus. (the purpose of off-campus is to leave the campus) *

Overdue detention hours *

The student must have his or her permanent ID on a given day, or the student may not go off campus that day *

Parents may revoke off-campus permission during lunch at any time by contacting the student’s dean.

As a parent of guardian, I give off-campus lunch permission.

Typing your name and date below indicate your consent for off-campus privileges.

Please complete your consent by typing your name *

A copy of your responses will be emailed to the address you provided.

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