After School Pick Up Form
Please fill out this form to provide information about your child's after-school pick up arrangements.
Child's Name
First Name
Last Name
Grade
Parent/Guardian's Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Pick Up Person
First Name
Last Name
Relationship to Child
Transportation Method
Walk
Drive
Public Transportation
Other
Emergency Contact Name
First Name
Last Name
Emergency Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Comments
Parent/Guardian Signature
Submit
Should be Empty: