Authorized Pick-Up Form
Please provide information on any adults who are authorized to pick your child/children up from GFS&T Summer Youth Camp. If you have more than one camper in your family, only one form is needed.
Camper(s) Name(s):
Parent/Guardian Information
Parent/Guardian #1
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Parent/Guardian #2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Emergency Contact Information
Emergency Contact (other than parent)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Camper
Adults Authorized to Pick-Up (other than parents/guardians above)
Alternative Pick-Up Guardian 1 (e.g. Grandparent, Nanny, Au Pair, Daycare)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Camper
Alternative Pick-Up Guardian 2 (e.g. Grandparent, Nanny, Au Pair, Daycare)
First Name
Last Name
Email
example@example.com
Relationship to Camper
Parent/Guardian Authorization
Parent's Signature
Parent's Name
First Name
Last Name
Date form signed
-
Month
-
Day
Year
Date
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Should be Empty: