Opt-Out Form

This form will notify Canterbury that one or more of the children in your family will not be returning to the school for the 2021-22 school year and therefore will not be included in Continuous Enrollment. If you are only un-enrolling a part of your family while choosing to keep others enrolled, you will need to fill out both this Opt-Out Form as well as the Continuous Enrollment Form.

*First Name

*Last Name

*Email

name@email.com

*Number of Students being Withdrawn

*Please select the applicable opt out school year.

*Student name(s)

Student Current Grade

Your feedback is important. What are the reasons behind your decision?

*Reason for Leaving

*School child will be attending

*Signature

E-signature required

*Date

MM/DD/YYYY

Opt-Out Enrollment Form

Canterbury School