Alternate Pick-Up Authorization
If you want to grant permission in a special case for your child to be released to another adult, please submit this form no later than 1:30 on the day in question.
Your Name (Parent)
*
First Name
Last Name
Email
*
example@example.com
Phone number where you can be reached if we have a question.
*
-
Area Code
Phone Number
Is this a one-time request or standing arrangement?
*
One-time
Standing
On what day do you want to release your child(ren) to another person for pickup?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
For a standing arrangement, for which school year are you granting permission to release your child(ren) to another person for pickup?
2025-26
Please list the students you wish to release to another person? (If multiple children will be released to the same person, then you can check "Same as above" after filling in the person's name the first time.)
Rows
Student First Name
Student Last Name
Level
Release To First Name
Release to Last Name
Same as above
1
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
2
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
3
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
4
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
5
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
6
Grammar 1
Grammar 2
Logic 1
Logic 2
Freshman
Sophomore
Junior
Senior
By signing below, I authorize Greenhouse to release the child(ren) listed above to the person(s) listed above for the date(s) specified.
Submit
Should be Empty: