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STUDENT PICK UP AUTHORIZATION

Individuals listed as emergency contacts are authorized to pick up the student from Challenger School. Please specify any other persons who are also authorized for only carpool pick up.

NAME: Jane Doe
RELATIONSHIP: Mother
HOME PHONE: 888-888-8888
WORK PHONE: 888-888-8888
EMAIL ADDRESS: name@email.com
NAME: Jane Doe
RELATIONSHIP: Mother
HOME PHONE: 888-888-8888
WORK PHONE: 888-888-8888
EMAIL ADDRESS: name@email.com
NAME: Jane Doe
RELATIONSHIP: Mother
HOME PHONE: 888-888-8888
WORK PHONE: 888-888-8888
EMAIL ADDRESS: name@email.com

ADDITIONAL PERSON FOR STUDENT CARPOOL