
L: Roberto Parent(s)/Guardian(s): Clemente Middle School Date of Birth: I certify that I am the custodial parent/legal guardian of the above named student, and I grant permission for my student to be released to any of the following individuals in the event of an Emergency/Crisis that requires the school to release the students using parent/child reunification protocols at my student s school. (Each section must be completed.) My child may be released to the following individuals. (Addition.
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How to fill out the MD MCPS Form 236-1 online
This guide provides clear and detailed instructions on how to fill out the MD MCPS Form 236-1 online. The form serves an important purpose in authorizing the release of students during emergencies or crises, ensuring their safe reunification with authorized individuals.
Follow the steps to complete the MD MCPS Form 236-1 online.
- Click ‘Get Form’ button to obtain the form and open it in your editor.
- Enter the student’s name in the designated field to ensure accurate identification.
- Provide the name of the school where the student is enrolled to help staff locate the correct institution.
- Fill in the student’s date of birth to verify their identity.
- Certify your status as the custodial parent or legal guardian by checking the appropriate box.
- List the individuals to whom the student may be released in case of an emergency, including their names, relationships to the student, addresses, and phone numbers. If you wish to include more names, ensure to indicate that on a separate piece of paper.
- Complete the parent/guardian information section, including both parent's names as well as their home, work, and cell phone numbers.
- If applicable, specify the student’s after-school daycare provider and include their phone number.
- Review all provided information to ensure accuracy before submission.
- Once completed, save changes, download the completed form, print it for physical submission, or share it electronically as required.
Complete your MD MCPS Form 236-1 online now for a smooth and efficient process.
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