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18-19 Daily & Disaster Dismissal Form

 PLEASE FILL OUT ONE FORM PER STUDENT 

Grade*
State*

List below the names of all the people to whom you give permission for authorized Assumption personnel to release your student to on a daily basis, as well as in the event of a disaster. Please list at least three people who would not have difficulty getting to Assumption if you were not able to.

  1. Do not list yourself.
  2. Do not list Assumption staff as they cannot be responsible for individual students.
  3. Please inform those people listed below that you have done so. They should be aware that they are to come to school with a government issued identification card and pick up in the event of a disaster (earthquake, etc.). They will not receive a phone call. Please inform them of the school's student release protocol.
  4. Tune your radio to 1610 kHz (fixed information station).

Thank you!