Authorized Pick Up 
This is the yearly update to student's authorized pick up form. Authorized adults must be agreed upon by both parents/guardians unless custody paperwork has been turned into the office. If multiple forms are filled out, the name(s) that appear on both lists will be the assumed authorized adults until an agreement is reached. 
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Student's Name
Student's Grade
Form Completed By
Person 1: Name (first last) and Phone Number
Person 2: Name (first last) and Phone Number
Person 3: Name (first last) and Phone Number
Person 4: Name (first last) and Phone Number
Person 5: Name (first last) and Phone Number
Person 6: Name (first last) and Phone Number
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