SYLVANIA SCHOOL DISTRICT
TRANSPORTATION STUDENT RELEASE
2019 / 2020

School Student is Attending: 	Grade: 	

Student Name: 	

Home Address: 	Phone: 	

Parent/Guardian: 	

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Daycare /Sitter/ Alternate Location Name:

Address:

Phone:

Effective Date:

Permission is given to transport my child named above to the daycare/babysitter/alternate address listed above for the 2019-2020 school year. Please check only one box below.

   BEFORE SCHOOL ONLY    AFTER SCHOOL ONLY
    BEFORE & AFTER SCHOOL

NOTE:		Only Consecutive Monday–Friday requests within the child’s home Elementary attendance area and to SCS Childcare will be considered. (Please allow for a three (3) day notice of any transportation change)

Any change to this release will need to be communicated in writing by the parent/guardian to the school and to the Transportation Department as needed.

(Parent / Guardian)	(Date)

Sylvania Public Schools
ATTN: Transportation Dept.
4747 N. Holland-Sylvania Road, Sylvania, OH 43560

Telephone (419)  824-8686 I FAX (419)  824-8789