Form

rGeneration Approved Pick-up Authorization Form
At rGeneration, the safety and security of every child entrusted to our care is our priority. This form allows parents/legal guardians to identify the individuals who are authorized to pick up their child from rGeneration Children's Ministry.

Only individuals 16 years of age or older may be authorized to pick up a child. A copy of a valid government-issued photo ID must be provided for each authorized person listed on this form.

Identification may be uploaded with this form or emailed to rgen@risen-church.org.

Children will not be released to anyone who is not listed as an authorized pick-up person.
SECTION 1 - Child's Information
Child's Full Name

First NameLast Name
Child's DOB
Parent/Legal Guardian #1 Name

First NameLast Name
Parent/Legal Guardian #1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Legal Guardian #1 Email Address
example@example.com
Parent/Legal Guardian #2 Name

First NameLast Name
Parent/Legal Guardian #2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Legal Guardian #2 Email Address
example@example.com
Authorized Pick-up Persons
Please list all individuals age 16 or older whom you authorize to pick up your child from rGeneration. Each person listed must have a valid government-issued photo ID on file with rGeneration.
Configurable list
File Upload

Cancelof
Signature of Parent/Guardian #1 or #2
Should be Empty:

rGeneration Approved Pick-up Authorization Form