MYCamp Pick-Up Release Form

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To ensure the safety of your child(ren), we are asking all parents/guardians to complete this form for times when someone other than yourself may have to pick your child up from MYCamp. If a person is not included on this list, we will not release your child(ren) to them. If this form is not complete, we will only release your child to you.

We still ask that whenever possible, please inform us in the morning, send a note, or email MYC to let us know if someone other than yourself will be picking up your child.

Email *

Camper's Name(s):
*

Parent/Guardian 1 (Name/Relationship/Phone#)
*

Parent/Guardian 2 (Name/Relationship/Phone#)
*

Alternate Pick-Up 1 (Name/Relationship/Phone#)
*

Alternate Pick-Up 2 (Name/Relationship/Phone#)
*

Alternate Pick-Up 3 (Name/Relationship/Phone#)

Alternate Pick-Up 4 (Name/Relationship/Phone#)

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