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Los Angeles College Prep Academy
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Dismissal Authorization Form
Student Name
*
Answer Required
At dismissal time, I authorize my child to:
*
Answer Required
Walk
Take the bus
Be home without the direct supervision of an adult
Other:
I certify that the above is truthful and if circumstances change I will resubmit this form.
*
Answer Required
Yes
Parent or Guardian Full Name:
*
Answer Required
Date:
*
Answer Required
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