Peace of Mind Form
2019-20 CMS ASP
CMS After School Program
(optional)
At the Chadron Middle School After School Program we believe that all students
and those who are caring for them at home should have peace of mind and know
that their child is safe at all times when attending after school program. We do not
require that an adult enters the building to sign a student out. We release students
per parent phone call or students are allowed to sign themselves out at any time.
This is left entirely up to the parent or guardian. You are the ones that know your
child best. There can also be quite a bit of a difference in maturity and sense of
responsibility from one student to the next. Therefore, if you would like your child
to remain at ASP until a certain time, please complete the bottom half of this sheet
and return it to the Middle School Office. If at any time you decide that this is no
longer necessary, Just send an email or call our office to let us know. As always,
we will do our best to meet your expectations when it comes to the safety of your
child. Thank you for your support.
and those who are caring for them at home should have peace of mind and know
that their child is safe at all times when attending after school program. We do not
require that an adult enters the building to sign a student out. We release students
per parent phone call or students are allowed to sign themselves out at any time.
This is left entirely up to the parent or guardian. You are the ones that know your
child best. There can also be quite a bit of a difference in maturity and sense of
responsibility from one student to the next. Therefore, if you would like your child
to remain at ASP until a certain time, please complete the bottom half of this sheet
and return it to the Middle School Office. If at any time you decide that this is no
longer necessary, Just send an email or call our office to let us know. As always,
we will do our best to meet your expectations when it comes to the safety of your
child. Thank you for your support.
Contact us: Danielle Woods - CMS ASP Site Coordinator
308.432.0508
Lorna Eliason - Program Director
308.432.0508
Program Hours: Monday- Thursday, 3:18 pm-6:00 pm
Early out Fridays, 1:30pm-4:30pm
_________________________________________________________________
Student Name:____________________ Grade:______ Date:______________
Parent Name:_______________________ Phone#:_______________________
Parent or Guardian Request:__________________________________________
________________________________________________________________
________________________________________________________________
Parent Signature:_______________________________ Date:______________
Student Signature:______________________________ Date: ______________
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