Sign Out Form — Westchester Elementary PTA

Kids Club Sign-Out Form

We know that sometimes life gets in the way and your student might need to miss a club session. When that happens we want to be sure that your student is dismissed to the correct place (Open Door, car line, walker door) rather than sent to clubs at dimissal time.

When you use this form to let us know, an email will go to your student’s homeroom teacher, the clubs facilitator, and Ms. Baldwin and Ms. Foster in the front office. That way everyone who is involved in getting all of our students to the right place at dismissal time will know exactly where to send your student.

Student Name

First Name

Last Name

Parent Name

First Name

Last Name

Parent Email

Parent Phone

(###)

###

####

Club

Homeroom Teacher

We automatically email the front office and the clubs teachers and facilitators. We'll use your answer here to include your student's homeroom teacher as well. If someone else should be notified instead (for example, 5th grader's afternoon teacher) please put that email address here.

Date of Session to be Missed

YYYY

Special Dismissal Instructions

Please let us know here if your student will be excused early that day or we will be looking for them at the end of the school day to get them to their regular dismissal location! If you have any other notes about dismissal for this day, please put them here. Thank you!