I give permission for my child, listed below, to leave the school with the grandparent/grandfriend, listed below, on May 10th 2024.

Grandparents/Grandfriends will need to have all transportation items such as car seats with them in order to take a child home.

Child Information

Childs Name

First Name

Last Name

Classroom

Grandparent/Grandfriend Information

Grandparent/Grandfriend Name

First Name

Last Name

Address as it appears on thier licence

Parent Signature

Signature of Parent or Legal Guardian.