Leaving Campus Permission

Map Academy provides all students with breakfast, lunch and snacks every day free of charge. Any student who is at least 16 years old but under 18 years old who wishes to receive the privilege to leave campus for lunch must submit this completed form and follow all expectations listed below.

Student Name(Required)
MM slash DD slash YYYY

As the parent/guardian of the student above, I am aware of the “Leaving Campus” privilege available to my student. By signing this form, I consent to my student leaving campus for the lunch period which begins at 11:30 am and ends at 12:15 pm. I fully understand that the school will not provide off-campus supervision, nor will the school be responsible for my student during the time they are off campus.

I further understand that this is a privilege and conditioned upon the following expectations:

  • Mature and responsible conduct while off campus.
  • Arriving back on campus in time for class at 12:15pm.
  • Respect for property and personal rights of others and the community.
  • Not encouraging, transporting, or socializing off campus with students that do not have off campus permissions.

The student must sign out with a designated destination prior to leaving the building and must sign back in upon their return with times stated for each.

I agree that should my student act inappropriately while off campus by violating any of the expectations above or engaging in inappropriate or illegal conduct, this privilege shall be revoked. I further agree that if my student wants to leave campus at any time during the school day other than lunch, I am required to put this in writing every time by emailing dismissals@themapacademy.org. This email must include the time you are giving your student permission to leave, the destination you are approving and what time they will return. If you have any questions or concerns, please contact the school at 508-830-9500.

Form must be renewed yearly. Students will NOT be granted permission to leave for lunch if they have not filled out this form. Previous year’s forms will be honored for only the first week of the new school year. Students without signed forms must remain on campus during lunch until this form is turned in. Leaving campus without permission is a suspendable offense.

As the parent/guardian, I understand the expectations of this privilege and give my student permission to leave campus in accordance with the expectations listed above.
As the student, I understand the expectations of this privilege and agree to comply with all of them. I will be accountable for my actions while off campus and I understand that this privilege may be revoked.
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