Student Pick-Up List
Please fill out the list below to include those approved to pick up your child from school. Students will only be released to those listed below with a valid photo ID.
Please list each student in the family:
*
Name
*
Name
Relationship
Phone Number
*
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Name
Name
Relationship
Phone Number
Please enter a valid phone number.
Parent Signature
*
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: