2020-2021 Consent to Release Form 2020-2021 Consent to Release Form Please list below and submit the names, phone numbers, and relationship to child of persons other than parents allowed to pick up your child from school. Please include authorized dates of consent. This release form will be kept in your child's file. Written notification to your child's teacher on the day of pick up is still required. For multiple authorized persons, please fill out a new form for each new person. Name of Child* First Last Name of Authorized Person for Pickup* First Last Email* Phone Number*Relationship to Child*Authorized Start Date:* Date Format: MM slash DD slash YYYY Authorized End Date:* Date Format: MM slash DD slash YYYY Signature*Today's Date* Date Format: MM slash DD slash YYYY
