Pick up Authorization – Mount Olive Lutheran School

Authorization for Pick Up

In order to facilitate the dismissal of children and keep better track of them, we request that the following form be completed.

Family Name:

Child's Name:

Child's Grade:

Child's Name:

Child's Grade:

Child's Name:

Child's Grade:

Child's Name:

Child's Grade:

The following people are authorized to pick up my child(ren) from school:

Please remember to send a note to the child’s teacher if a change in this routine occurs. We are always concerned about the safety of your children. Also, remember that any child not picked up by 3:45 pm will be sent to aftercare and will be charged for the service.

All children are to be under adult supervision on the playground before, during and after school. They are not to be sent out to play while adults conduct business or volunteer in the building.

Today's Date

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