Annual Registration Form

Your child will only be released to an authorized person listed on this form (parent/guardian and/or emergency contact). In case of an emergency or an unforeseen circumstance, please indicate the name, address and phone number of any other person/s who you authorize to pick up your child on your behalf. A parent/guardian's written authorization for pickup must be received in person by parents/guardian before your child will be released to anyone not listed here. If not received, and we cannot notify you by phone, the child will not be released.