Pick-Up Form - Upper School

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Please complete this brief form to indicate that your child is being picked-up today. Please remember that the adult picking up your child must bring ID and be listed on your child's emergency form or your child WILL NOT be released. Emergency forms can be found on our school website at brennanrogersmagnetschool.weebly.com.

PLEASE COMPLETE THIS FORM BY NOON EACH DAY.

Date *

YYYY

Student(s) Name (First and Last) *

Adult picking up student (First and Last) *

Relationship to Student *

Grade (s) - If entering more than one grade, please write it in the order of the student names above. *

My name is listed on this student's emergency contact form.

Yes

I don't know

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