Sent Home: Name of Parent/Relative of __________________ Contacted Parent/Relative Not sent home: __________________________ Additional Information: Signatures required Signature Date Signature of Supervising Adult: Signature of Principal:
Name of Parent/Relative Contacted of Parent/Relative Sent Home: __________________ Not sent home: Additional Information: Signatures required Signature Date Signature of Supervising Adult: Signature of Principal: __________________________
PCES%20Safety%20and%20Crisis%20Response%20Plan%20Revised%2008152013.docx