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GIFT DESIGNATIONS
WAYS TO GIVE
DONOR BENEFITS
ANNUAL GIVING & MAJOR GIVING
SUPPORT TYM
About Us
Code of Conduct Policy
Student Attendance Policy
Appropriate and Inappropriate Verbal Interactions Policy
Non-Discrimination Policy
Zero Tolerance Policy
Contact
News
Menu
Home
Spring Registration
Support
GIFT DESIGNATIONS
WAYS TO GIVE
DONOR BENEFITS
ANNUAL GIVING & MAJOR GIVING
SUPPORT TYM
About Us
Code of Conduct Policy
Student Attendance Policy
Appropriate and Inappropriate Verbal Interactions Policy
Non-Discrimination Policy
Zero Tolerance Policy
Contact
News
Child Pick-up Authorization Form
PARENTS AND GUARDIANS: Please complete this form for each child you are registering.
Date
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
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25
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28
29
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31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
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1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Child's Name
First
Last
Parent/Guardian Signature
*
NO ONE WILL BE PERMITTED TO PICK UP YUR CHILD IF HIS OR HER NAME IS NOT LISTED BELOW. ALL PERSONS MUST HAVE AND SHOW THEIR PICTURE ID WHEN PICKING UP THE CHILD. PLEASE MAKE SURE YOU LIST ALL ADULTS EVEN IF YOU RESIDE IN THE SAME HOUSEHOLD.
THE FOLLOWING ADULTS ARE AUTHORIZED TO PICK UP MY CHILD FROM SCHOOL.
Parent/Guardian
*
First
Last
Cell Phone
Work Phone
Home Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Parent/Guardian
First
Last
Cell Phone
Work Phone
Home Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
PERSON(S) OTHER THAN PARENT/GUARDIAN AUTHORIZED TO PICK UP CHILD
Name
First
Last
Cell Phone
Work Phone
Home Phone
Relationship
Grandparent
Relative
Family Friend
Day Care Provider
Name
First
Last
Cell Phone
Home Phone
Work Phone
Relationship
Grandparent
Relative
Family Friend
Day Care Provider
Section End
Email
This field is for validation purposes and should be left unchanged.
