TVBC Eagles' Nest Registration

Special Instructions (if any)
Authorization for additional persons who may pick up child(ren) (ID Required)
Name (authorized person to pick up children)
Phone
Format: 000-000-0000.
Relationship
Name (authorized person to pick up children)
Phone
Format: 000-000-0000.
Relationship
Authorization to self-check out from Eagles' Nest (Grades 10-12 ONLY)
Name (authorized to self-check out)
Phone
Format: 000-000-0000.
Email
example@example.com
Name (authorized to self-check out)
Phone
Format: 000-000-0000.
Email
example@example.com
Parent/Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: