Permission to Leave

Permission to Leave with a Parent or Visitor

  • Notification of a student’s permission to leave with a parent or visitor must be requested at least two days in advance each time you or another approved visitor will sign the student out from the residence hall.
  • The submission of this form grants your child permission to leave his/her residence hall during the designated date(s)/time with you or another individual specified by you, the parent/guardian.
  • This includes permission to ride in a vehicle with the stated individual.
  • All visitors are required to show proof of ID at the time of student pick-up from the residence hall.

NOTE: The e-mail received at CPYB must be sent from the custodial parent/guardian e-mail address on file in the student's Family Portal in order to be considered for approval.

Please do not submit a form until your child’s residence hall has been assigned on Arrival Day.

Click on the your child's residence hall below to complete the "Permission to Leave with a Parent or Visitor" form:

Adams  |  Drayer  |  Matthews  |  Todd  |  Witwer

Having trouble with the above links? Simply copy and paste the following information into an e-mail and send to the appropriate residence hall director (addresses listed below):

adams@cpyb.org
drayer@cpyb.org
mathews@cpyb.org
todd@cpyb.org
witwer@cpyb.org

Subject: Permission to leave with a parent or visitor

Notification of a student’s permission to leave with a parent or visitor must be received by CPYB at least two days in advance of the student’s departure from the residence hall. Complete and electronically sign the following form.

PERMISSION TO LEAVE:

I, (ENTER CUSTODIAL PARENT/GUARDIAN'S NAME) give permission for (ENTER STUDENT NAME) to leave their residence hall on (ENTER DATE) from (ENTER TIMEFRAME) with (ENTER NAME OF PARENT/VISITOR). 

This parent/visitor may be contacted at (ENTER MOBILE PHONE NUMBER).

My electronically typewritten signature below shall be legally binding and serve in the same capacity as my original penned signature.

SIGNATURE (type full name):
DATE: