Permission to Leave or Ride in a Vehicle

Permission to Leave or Ride in a Vehicle

Notification of a student’s permission to leave or ride in a vehicle must be received by the CPYB office at least two days in advance of the student’s departure from the residence hall. The submission of this form grants your child permission to leave or ride in a vehicle with another individual. The permitted individual is required to show proof of ID at the time of student pick-up from the residence hall.

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

Click on the your child's residence hall below to complete the "Permission to Leave or Ride in a Vehicle Form":

Adams  |  Drayer  |  Matthews  |  Todd  |  Witwer

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

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

adamsdd@cpyb.org
drayerdd@cpyb.org
mathewsdd@cpyb.org
todd-dd@cpyb.org
witwerdd@cpyb.org

Subject: Permission to leave or ride in a vehicle

Notification of a student’s permission to leave or ride in a vehicle must be received by CPYB at least two days in advance of the student’s departure from the dormitory. Complete and electronically sign the following form and e-mail it. Your e-mail will be directed to the appropriate residential staff.

PERMISSION TO LEAVE:

I, ______________(ENTER CUSTODIAL PARENT/GUARDIAN'S NAME) give permission for ______________ (ENTER STUDENT NAME) to leave campus. My student is allowed to leave with myself or with any of the following person(s):

Name:
Phone:

Name:
Phone:

Name:
Phone:

PERMISSION TO RIDE IN A VEHICLE:

I, ______________ (ENTER CUSTODIAL PARENT/GUARDIAN'S NAME) give permission for ______________ (ENTER STUDENT NAME) to ride in the vehicle(s) of the following individual(s) during the 5-Week Summer Ballet Program.

Name:
Phone:

Name:
Phone:

Name:
Phone:

**This form must be electronically signed and dated by the Custodial Parent/Guardian of any student under the age of 18.**

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: