Carpool Authorization Form

Occasionally, you may have someone other than yourself or your spouse pick up your child from preschool. On such occasions, we need to be notified in writing who that person will be. Sending a note in your child’s bag the morning of the change will be sufficient notice. For your child’s safety, we will check their identification upon arrival to see that it matches your prior written note.

Please list below those persons other than yourself who are authorized to pick up your child:

Name – Relationship to Child *

Name *

First

Last

If the person picking up your child is not listed above and you did not send a note with another name, we will not be able to release your child to that person. By entering your name here, you confirm that you have read and understand this policy.

Submit