PICK-UP AUTHORIZATION FORM

To provide máximum safety for the children at camp we ask you to fill out this form to inform
the staff who is allowed to pick-up your child and the foreign child in your care.

PARENT / LEGAL GUARDIAN FULL NAME + ID NUMBER:

As parent or legal guardian of the child

CHILD FULL NAME:

allow the following person(s) to pick-up my child and the child in my care at the end of the day
in case I could not pick them up:

FULL NAME ID NUMBER

ALLOWED
PERSON 1

ALLOWED
PERSON 2

ALLOWED
PERSON 3

ALLOWED
PERSON 4

ALLOWED
PERSON 5

And I exonerate the Organization from any responsibility arising from the actions of the allowed
person(s) once they have picked up the children.

I will also inform the Organization in case of revoking the authorization of any of the persons on
the list by sending an e-Mail from the adress provided to the organization

To expand the list, just send an e-Mail from the adress provided to the organization indicating
full name and ID Number of the new authorized person.

SIGNED___________________________________