CREATE Summer Camp Pick Up Authorization Form
Please list the names of all persons authorized to pick up your child(ren). If your child will be picked up by someone not on this list, please let CREATE staff know at drop off or via email (provide the full name and relationship to your child(ren) of the person who will be doing the pick up).
Email address *
Last Name of Child(ren) Attending Camp *
First Name of Child(ren) Attending Camp *
Camp Sessions *
Please check ALL sessions for which your children are registered:
Required
Name of Parent/Guardian Submitting Form *
Authorized Person #1 *
Please list full name, cell phone number, and relationship to child(ren)
Authorized Person #2
Please list full name, cell phone number, and relationship to child(ren)
Authorized Person #3
Please list full name, cell phone number, and relationship to child(ren)
Authorized Person #4
Please list full name, cell phone number, and relationship to child(ren)
Authorized Person #5
Please list full name, cell phone number, and relationship to child(ren)
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