Authorize Release Form

Child's Name*
First Last
Release Statement*
I authorize my child to be released from Precious Lambs Preschool to the following people. Authorized people on the list may be asked to show a Driver’s License/Photo ID. Please do not list parents as both are legally authorized to pick-up the child unless we have a court document on file.
Person 1 (Required)
Name of Person*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Person 2 (Optional)
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone
Person 3 (Optional)
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Date*
MM slash DD slash YYYY
Parent Name*
First Last
Parent Signature*
Email
This field is for validation purposes and should be left unchanged.

Person 1 (Required)