Full Name(s) of Individual(s) Authorized to Pick up my Child (must be 18 years of age or older and present valid ID)*
List any conditions you feel we need to know to properly care for your child/children. Examples include food or other allergies, anxiety, or a physical impairment.*
Should a child/children require any medical attention during this period, list any special instructions that might be required (e.g. current medications, allergies to drugs, rare blood type).