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Pickup Authorization Change Form
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Diamond Crest Day Camp - Pickup Change Authorization Form

If you need a person other than parents and Authorized Pickup Persons listed on your camper’s registration form to pick up a camper, or need to change their Walk status, please print, fill out and sign this form and hand it to your camper’s BUS LEAD in the morning.

Camper Name

Unit Number

Camper may walk home from the bus

Yes         No

Pickup Person

Pickup Person Phone

Pickup Date(s)

Parent/Guardian Name: ________________________________ Phone: __________________

Parent/Guardian Signature: ______________________________________________________

Note: Only those listed as Parent/Guardian 1 or 2 on the registration form are authorized to sign this form for a camper.

***********************************************************************************************************************

Section for Diamond Crest Day Camp Volunteers Only (Confirm Information Reviewed and Recorded)

▢ Bus Lead_________________                        ▢ Attendance__________________                                          (date/initials)                                                         (date/initials)

Diamond Crest Day Camp - Pickup Change Authorization Form

If you need a person other than parents and Authorized Pickup Persons listed on your camper’s registration form to pick up a camper, or need to change their Walk status, please print, fill out and sign this form and hand it to your camper’s BUS LEAD in the morning.

Camper Name

Unit Number

Camper may walk home from the bus

Yes         No

Pickup Person

Pickup Person Phone

Pickup Date(s)

Parent/Guardian Name: ________________________________ Phone: __________________

Parent/Guardian Signature: ______________________________________________________

Note: Only those listed as Parent/Guardian 1 or 2 on the registration form are authorized to sign this form for a camper.

***********************************************************************************************************************

Section for Diamond Crest Day Camp Volunteers Only (Confirm Information Reviewed and Recorded)

▢ Bus Lead_________________                        ▢ Attendance__________________                                          (date/initials)                                                         (date/initials)