Change of Dismissal Form

Notify us of a temporary change in dismissal routine.

Parents and guardians, you can complete this form to request a temporary change in dismissal routine.

All online requests should be made by 2:00 p.m. For any changes or emergencies after 2:00 pm, please contact the office at 703-249-1400.
Form response will be forwarded to the classroom teacher indicated. If you have multiple Terra Centre students for whom this change applies, you must complete this form for each child.
Permanent dismissal changes must be reported to your child’s teacher by email.

This form can only be filled out by the student's legal guardian.

Date of Transportation Change:

Student First Name:

Student Last Name:

Classroom Teacher:

Transportation Option:

Assigned bus number:

Person picking up student:

Time of early pickup:

Additional information for transportation change, if any:

Parent Info

Parent / Guardian Name

Parent / Guardian Phone

Parent / Guardian Email

Legal Guardian Confirmation

By submitting this form, you are confirming that you are the parent or legal guardian of the student.