Authorized Pick Up
You may enter up to 4 people you authorize to pick up your child. If you do not authorize anyone other than child's parents, you will still complete this form selecting parent only, signing, and submitting.
Child's Name
First Name
Last Name
Select your child's class:
Explorers
Explorers with Early Bird
Explorers with Lunch Bunch
Investigators
Investigators with Early Bird
Investigators with Lunch Bunch
Investigators with Researchers
Investigators with Researchers and Early Bird
Investigators with Researchers and Lunch Bunch
Parent/Guardian's Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Can anyone other than the parents pick up your child?
Please Select
Yes
No
If parents are the only ones who are authorized to pick up the child, please scroll down and submit form.
Pick Up Person 1
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child
Pick Up Person 2
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child
Pick Up Person 3
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child
Pick Up Person 4
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child
Parent/Guardian Signature
Submit
Submit
Should be Empty: