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Amandas Garden

It is important that our children are as safe as possible. Amandas Garden has developed a pick-up policy for our staff. We are concerned about your child and who may pick him or her up each day. We must have a list of all possible people who may pick up your child with a maximum of 3, In addition to parents. If there are any changes, we must be notified when your child is dropped off. The arrangement will be on a day to day basis, if it is a permanent change, a new pick-up policy form must be filled out. A child will not be permitted to leave with anyone other than those listed on this form unless we have your written permission. We will request to see proper identification if we do not know the person. Please inform those people whom you list on this form that they must have proper identification. If different people for different children you will have to sign a form for each child. Childrens NAME: List persons permitted to pick up your child and the relationship to the child and phone number. Name ___________________________________ ___________________________________ ____________________________________ ____________________________________ ____________________________________ Relationship Mother Father _______________ _______________ _______________ Phone # ________________ ________________ ________________ ________________ ________________

Parent Signature__________________________________ Date______/________/______

Pick up policy.doc Updated 2/07