Pick-up Authorization

"*" indicates required fields

Name of Child*

First Last

Grade of Child*

Casa A

Casa B

Casa C

Casa D

1A

1B

2A

2B

3A

3B

4A

4B

5A

5B

6A

6B

7A

7B

8A

8B

Hifdh A

Hifdh B

Hifdh C

Please fill the information below if the child is not picked up by the parents.

Name of Person 1 Authorized to Pick up*

First Last Relation to the child

Phone Number #1 of Person 1 Picking up

Phone Number of Person 1 Picking up

Name of Person 2 Authorized to Pick Up

First Last Relation to the child

Phone Number #2 of Person 2 Picking up

Phone Number of Person 2 Picking up

Parent Email*

Δ

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