forms

Additional Person Authorized to Pick Up My Child

Child's Name *

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Primary Contact *

Primary Home Phone

Primary Work Phone

Primary Relationship

Primary Cell Phone

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Secondary Contact *

Secondary Home Phone

Secondary Work Phone

Secondary Relationship

Secondary Cell Phone

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Additional Contact (One) *

Additional Home Phone (One)

Additional Work Phone (One)

Additional Relationship (One)

Additional Cell Phone (One)

Additional Contact 2

Additional Contact (Two) *

Additional Home Phone (Two)

Additional Work Phone (Two)

Additional Relationship (Two)

Additional Cell Phone (Two)

Additional Contact 3

Additional Contact (Three) *

Additional Home Phone (Three)

Additional Work Phone (Three)

Additional Relationship (Three)

Additional Cell Phone (Three)

Checkboxes

I agree

I authorize the individuals listed on this sheet to pick my child up in the event that I may not be able to pick them up. I agree to notify Sunnyside Academy in advance via telephone as well as making changes in the School App to inform them of the change.

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Parent/ Guardian E-Signature (One) *

Parent/ Guardian E-Signature (Two) *

Date (Parent/Guardian)(One)

Date (Parent/Guardian)(Two)