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Machon Micah Early Pick-up Permission Form
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In the interest of safety and the least possible disruption of our classes, we ask that if your child absolutely must leave before the end of our scheduled sessions that you please submit this form at least 2 hours prior to the start of our class sessions.
Student Information
*
Student Name
*
Student Grade
Please Select One
PreK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
R2B (8th-12th Grades)
Early Pick-up Information
*
Please specify the date your Child will be picked up early:
*
Please specify the time your Child will be picked up early:
*
Who will be picking up your Child?
Please enter the full name and their relationship to your child.
*
Reason for Early Pick-up
Sun, November 3 2024 2 Cheshvan 5785