Maroon Card holders are entitled to have an off-campus lunch (1 hour) on the designated day of each month as listed below.  It is the responsibility of each student to have this form completed with all signatures prior to leaving campus. You need only to have this form signed once.  It will cover all the dates listed below.

 If you do not have a full hour for lunch and have a half-hour music class/study hall before or after your lunch period, you must have your teacher sign this form also. 

Extreme caution should be taken when leaving and returning to campus. Furthermore, it is your responsibility to return to campus on time for your next class.

_____________________________                              9            10           11           12

            Please print name                                                  Circle one

Date of release:                                                              10/12           11/9             12/14     

Lunch period:                    3            4            5             _________________________     

                                              Circle one                        Teacher Signature

_____________________________________

Student Signature and ID Number

___________________________

Parent Signature

__________________________

Assistant Principal Signature