2026-2027 Request for Temporary Change of Dismissal

Dismissal changes are intended for emergency or temporary transportation changes only and should not be used for routine or daily transportation arrangements. To help ensure the safety of every student, please review the following information before submitting your request:

- Requests must be submitted no later than 3:00 PM on regular school days.
- On Early Release Days, requests must be submitted by 1:00 PM (October 28, 2026; January 27, 2027; and February 24, 2027).
- Requests submitted after the applicable deadline cannot be guaranteed and may not be accommodated.
- Any person picking up a student must present a valid government-issued photo ID.
- Submission of this form does not guarantee approval, as the school may need to verify the request before making any dismissal changes.

Please help us ensure a safe and efficient dismissal by limiting change requests to emergency or temporary situations.

STUDENT INFORMATION
Student Name Student Name First Last
Grade
Homeroom Teacher's Name
Student ID #
ADDITIONAL STUDENT INFORMATION
(if applicable)
Is this request for addtional students?

Is this request for addtional students? Yes - Complete the additonal student fields below No - Skip to Change Details
Student Name (2) Student Name (2) First Last
Student ID #
Grade
Homeroom Teacher's Name
Student Name (3) Student Name (3) First Last
Student ID #
Grade
Homeroom Teacher's Name
CHANGE DETAILS
Type of Change

Type of Change Today Only Temporary Change Permanent Change
Effective Date Effective Date / MM / DD YYYY
End Date (if temporary) End Date (if temporary) / MM / DD YYYY
CURRENT DISMISSAL METHOD
Student's Normal Dismissal

Student's Normal Dismissal Car Rider Bus Rider Walker/Biker Escorted (meets adult at Mystic) Walker/Biker Unescorted (does NOT meet adult at Mystic) Daycare/Program Name (Name REQUIRED)
Please indicate Daycare/Program Name or Bus Number
(N/A if non-applicable)
NEW DISMISSAL METHOD
Student's NEW Dismissal

Student's NEW Dismissal Car Rider Bus Rider (Active Bus Pass REQUIRED) Walker/Biker Escorted (meets adult at Mystic) Walker/Biker Unescorted (does NOT meet adult at Mystic) Daycare/Program Name (Name REQUIRED)
Please indicate Daycare/Program Name or Bus Number
(N/A if non-applicable)
PARENT/GUARDIAN REQUESTING CHANGE OF DISMISSAL
Name of Requestor (MUST be a custodial adult listed in myStudent) Name of Requestor
(MUST be a custodial adult listed in myStudent) First Last
Email Address of Requestor
Contact Number of Requestor Contact Number of Requestor - ### - ### ####
Additional Information
ACKNOWLEDGEMENT
Please review each statement below and check each box to acknowledge your understanding before submitting your request.

Please review each statement below and check each box to acknowledge your understanding before submitting your request. I understand that dismissal change requests must be submitted before 3:00 PM on regular school days (1:00 PM on Early Release Days). I certify that I am the parent/legal guardian or an authorized emergency contact for the student(s) listed on this request. I understand that Seven Oaks Elementary may contact me to verify this dismissal change request before making any changes. I understand that dismissal change requests submitted after the deadline may not be accomodated I verify that the information provided on this form is complete and accurate to the best of my knowledge. I understand that this request applies only to the dates specified on this form and that my child's regular dismissal plan will resume unless a new request is submitted or a permanent dismissal change has been approved.
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.

2026-2027 Request for Temporary Change of Dismissal

2026-2027 Request for Temporary Change of Dismissal

STUDENT INFORMATION

ADDITIONAL STUDENT INFORMATION (if applicable)

CHANGE DETAILS

CURRENT DISMISSAL METHOD

NEW DISMISSAL METHOD

PARENT/GUARDIAN REQUESTING CHANGE OF DISMISSAL

ACKNOWLEDGEMENT

ADDITIONAL STUDENT INFORMATION
(if applicable)