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Opt-Out Enrollment Form
Please enter all required information.
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.
Parent Name
*First Name
*Last Name
*Email
name@email.com
*Number of Students being Withdrawn
1
2
3
4
5
*Please select the applicable opt out school year.
Current School Year
Next School Year
Student Name
*Student name(s)
Student Current Grade
PK3
PK4
K
1
2
3
4
5
6
7
8
9
10
11
12
Your feedback is important. What are the reasons behind your decision?
*Reason for Leaving
*School child will be attending
Signature
*Signature
E-signature required
*Date
MM/DD/YYYY
Canterbury School
8141 College Parkway, Fort Myers, FL 33919
239-481-4323
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