JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
AUTHORIZATION TO PICK UP CHILD PRE-K
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Session your child is enrolled in:
*
Choose
AM 8:30- 11:00
PM 12:15-2:45
Name of child (first last)
*
Your answer
Authorized to pick up -Person 1
*
Choose
Mother
Father
Aunt/Uncle
Grandparent
Other
Person 1 Name (Please Enter Full Name)
*
Your answer
Person 1 Contact Number
*
Your answer
Authorized to pick up -Person 2
Choose
Mother
Father
Aunt/Uncle
Grandparent
Other
Option 6
Name of Person 2 (Please Enter Full Name)
Your answer
Person 2 Contact Number
Your answer
Authorized to pick up -Person 3
Choose
Mother
Father
Aunt/Uncle
Grandparent
Other
Name of Person 3 (Please Enter Full Name)
Your answer
Person 3 Contact Number
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Salem School District.
Report Abuse
Forms
