Pick-Up Authorization

Please list the names of people who have permission to pick up your child from First Five on an ongoing basis. Please include the relationship of that person to your child (i.e. Nanny, Father, Grandmother, etc.). Play-dates and other special arrangements will require a note from you on those occasions. Thank you for your help in keeping dismissal safe and efficient.

Name of Child *

Name of Parent Filling Out Form *

Email *

Phone *

Name * Relationship *