Krystal Dismissal Change Form

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This form is used to make permanent changes to your student's dismissal instructions.
Please note that changes must be submitted at least 2 hours prior to dismissal to be made effective the same day.

Temporary changes may be emailed to michelle.karlen@hesperiausd.org

Email *

Student Name *

Grade *

Teacher *

Parent Name *

New dismissal instructions *

DRIVE UP (parent remains in car, drives through pick up line to front of school where student is waiting)

WALK UP (parent parks car in west side of parking lot and walks up to double gate near cafeteria to pick up student)

WALKER - (student escorted out through the gate on Farmdale Ave and is crossed to dirt lot on corner of Krystal Dr and Farmdale Ave where student is released to independently walk) PLEASE NOTE: Student will be given a temporary pass and a permission slip to be signed by parent/guardian and returned to Office..

Date for new dismissal to start *

YYYY

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