Student Pick Up Authorization

Student Pick Up Authorization
At Faith Christian Academy, your child’s safety and well being is our top priority. In order to make sure that this mission is carried out, we need your help.

Please indicate the name(s) and phone numbers of the people who are allowed to pick up your child from school. Thank you!
Student Name*

First NameLast Name
Parent or Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone*
Please enter a valid phone number.
Pick Up Name #1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Pick Up Name #2

First NameLast Name
Phone Number
Please enter a valid phone number.
Pick Up Name #3

First NameLast Name
Phone Number
Please enter a valid phone number.
Pick Up Name #4

First NameLast Name
Phone Number
Please enter a valid phone number.
Pick Up Name #5

First NameLast Name
Phone Number
Please enter a valid phone number.
I herby authorize any of the above named people to pick up my student from school or school activities.*

YES
Parent or Guardian Signature*

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