Dismissal Form


LILLIE B. MERRILL ELEMENTARY SCHOOL
DISMISSAL NOTIFICATION FORM


DATE:______________________

CHILD'S FULL NAME: _______________________________________________________

TEACHER'S NAME:    _______________________________________________________

My child will be picked up early today. He/She will be dismissed at (time)                      by                                                             .

My child will be picked up at the end of the day by:                                                                     

NOTE: All children being picked up at the end of the day will be waiting in the gymnasium where wschool personnel will be located at 3:10p.m. fo you to sign them out


Parent Signature: 


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