B Lunch Check-Out Form

If you would like your student to have permission to leave school at the beginning of "B" lunch, which begins at 12:59 PM, you must complete this form for us to keep on file. Please reiterate to your child that the expectation is that they leave our campus immediately at 12:59 PM.

Student Name* Student Name* First Last
Student Number*
Grade Level*

Grade Level* 9th 10th 11th 12th
Parent/Guardian Name (Must match in MyStudent)* Parent/Guardian Name (Must match in MyStudent)* First Last
Parent/Guardian phone number is required & must match MyStudent.* Parent/Guardian phone number is required & must match MyStudent.* - ### - ### ####
Parent/Guardian email is required and must match MyStudent.*
Parent/Guardian Signature * 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.