Student Release Form

                         

 The QUENTIN ROAD CHRISTIAN PRESCHOOL has

my permission to release my child/children,Child's Name 

to the following person(s),

Person's Name

on the following date(s),

Date

Special instructions:


Please check the following:

 This is for the above dates only.

 This person has my permission to pick up my child/children at any time.



Parent's Signature  

Parent's Signature*Filling Out This Box is the Equivalent of Your Signature 

Parent's Email

                Required to receive confirmation of request