SBK8 Change of Dismissal

Please complete this form to notify our school of a change of dismissal for your student. This form must be submitted before 3:15pm on the day of the dismissal change.

Today's Date Today's Date / MM / DD YYYY
Student Name
Student Number
Teacher Name
Parent/Guardian Full Name
Phone Number
Email address
Normal mode of transportation
Change my child's transportation to:

Change my child's transportation to: Car Rider Hiker/Biker GREEN GO - this means my child can walk or bike home without an adult. Hiker/Biker ORANGE - my child must be released to an adult to walk/bike home. Bus Rider (this can ONLY be chosen if your child already has a bus pass) PLACE Other
If "other" is selected, please give description of transportation type:
This is a permanent change.

This is a permanent change. Yes. No.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
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2, 1, 8, 3 : which of these is the largest?