We will release your child only to the person listed on this form. This includes emergency pickups. Please try to include all persons that may pick up your child at any time.
Parents, it is your responsibility to let us know if you want to add or take a name off the list. Please keep us current on new telephone numbers. Each person that picks up your child has to have a code. You assign each person that you want to pick up your child a code.
THE I.D. CODE MUST BE FOUR ALPHA AND/OR NUMERIC DIGITS. EACH PERSON’S CODE HAS TO BE DIFFERENT.
They must know their code in order to pick up the child.

Status level will let us know how much information you want each person to know about your account with us. Each person will have to show proof of ID the first time they pick up the child.

NO VERBAL RELEASES ALLOWED.
TOP LEVEL = PARENT
MED LEVEL = OTHER RELATIVE
LOW LEVEL = FAMILY FRIEND/BABYSITTER, ETC.