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Laconic Hills Central School District STUDENT RELEASE / EMERGENCY DISMISSAL FORM Student's Name: Birth Date: (Last) (First) Student ID #: Lives With: Teacher: Grade: Parent/Guardian Name: Home Phone:
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How to fill out student release emergency dismissal
How to Fill Out Student Release Emergency Dismissal:
01
Obtain the necessary form: The school or educational institution should provide you with a student release emergency dismissal form. If you don't have one, contact the school administration to obtain it.
02
Fill in personal information: Start by providing your child's full name, date of birth, grade, and other relevant personal information requested on the form. Make sure to double-check the accuracy of the information provided.
03
Emergency contact details: Provide the contact information for at least two emergency contacts who can be reached in case of any unforeseen circumstances. Include their names, phone numbers, and their relationship to the child. Ensure that the contacts listed are easily reachable during school hours.
04
Specify authorized adults: Indicate the names and contact information of any individuals other than the parents or legal guardians who are authorized to pick up your child in case of an emergency. This could include grandparents, close family friends, or trusted neighbors. Make sure to inform the authorized adults that they may be contacted in such situations.
05
Medical and allergy information: Include any essential medical information, such as existing allergies, medical conditions, or required medications. Ensure that this information is accurate, up-to-date, and clearly stated to ensure the correct handling of your child's health situation in an emergency.
06
Signatures and dates: Sign and date the form in the designated areas to validate your consent and agreement to the terms outlined in the student release emergency dismissal form. Make sure to read and understand all the information provided on the form before signing.
Who Needs Student Release Emergency Dismissal:
01
Parents and legal guardians: Student release emergency dismissal is primarily intended for parents or legal guardians who want to ensure that their child can be released safely and promptly in case of emergencies or unforeseen events during school hours.
02
Educational institutions and school administrators: Student release emergency dismissal forms are designed to assist schools in efficiently managing emergency situations. It helps them ensure the safety and well-being of students by having the necessary information and permissions on file.
03
Emergency contacts and authorized adults: This form may also be relevant for individuals listed as emergency contacts or authorized adults who are authorized to pick up a child in case of emergencies. Being aware of a child's emergency dismissal process allows these individuals to be prepared and ready to take appropriate action when needed.
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What is student release emergency dismissal?
Student release emergency dismissal is a form used to authorize someone other than a parent or guardian to pick up a student from school in case of an emergency.
Who is required to file student release emergency dismissal?
The student's parent or legal guardian is required to file the student release emergency dismissal form.
How to fill out student release emergency dismissal?
The form must be filled out with the student's information, the authorized person's information, and signed by the parent or legal guardian.
What is the purpose of student release emergency dismissal?
The purpose of student release emergency dismissal is to ensure that students are safely released to authorized individuals in case of an emergency.
What information must be reported on student release emergency dismissal?
The form must include the student's name, date of birth, the name and contact information of the authorized person, and any special instructions.
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