Child Pick Up Authorization - Design 1


Child Details


Please enter:

Full Name

Grade

Gender

1
 
 
 
2
 
 
 
3
 
 
 
4
 
 
 


I authorize the people including parents/guardians listed below to pick up my child/children from school.


Please enter details of parents/guardians here:

Full Name

Relationship to child

Address

Work Phone

Mobile Phone

 
 
 
 
 
 
 
 
 
 

Please enter details of other people here:

Full Name

Relationship to child

Address

Work Phone

Mobile Phone

 
 
 
 
 
 
 
 
 
 


Parent/Guardian Signature

Parent/Guardian Signature


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