Student Pick Up Authorization

I hereby inform Colossal Academy that the people listed below are authorized to pick up the above named child/ren at any time. Accordingly, Colossal Academy is hereby instructed to release my child/ren into the care of the following people whenever they come to the Center. AUTHORIZED PICK-UP PERSON (must be a minimum of 18 years old unless special written arrangements and must show ID).

Approved Full Name (Adult #1)

Relationship to child (Adult #1)

Phone (Adult #1)

Approved Full Name (Adult #2)

Relationship to child (Adult #2)

Phone (Adult #2)

Approved Full Name (Adult #3)

Relationship to child (Adult #3)

Phone (Adult #3)

I understand that: Parents/guardians must inform Colossal Academy in writing when the name of the person listed above will pick up their child/ren. This applies when the child’s normal pickup routine varies. Any person that picks up your child/ren maybe asked to provide a photo ID to the staff if they are not familiar with the person on the above list. This document shall remain valid until edited or rescinded in writing by the parent/guardian.

Authorized by:

Signature

Student Pick Up Authorization

Main School and Admissions: 754-444-9929

admin@colossal-academy.com

746 NE 3rd Ave
Fort Lauderdale, Florida

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