Kids Club Carpool / Pick-Up Consent Form

Please complete this form to authorize another individual or St. Angela Merici Kids Club family to pick up your child(ren) from Kids Club.
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- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Contact REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Your Car Tag # REQUIRED Please fill out this field. Please enter valid data.
- Please list all Kids Club students in your family that will be picked-up
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Child 2
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Child 3
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Child 4
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Child 5
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Child 6
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Session REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
- The following individuals have premission to pick up your child(ren) from class. (Please list anyone other than parent(s)/guardian(s) including, but not limited to, babysitters, nannies, grandparents, neighbors, etc): These individuals will be given an Authorized Car Tag with your family number.
- Authorized Individuals to Pick Up REQUIRED Please fill out this field.
  
  Individual 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Individual 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Individual 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Individual 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Relationship REQUIRED Please fill out this field. Please enter valid data.
- If your family will be carpooling on a regular basis with another St. Angela Merici Kids Club family, list them below to give permission for them to pick up your children. This family will be given an Authorized Car Tag with your family number.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- I understand this form gives permission to the above individual(s) to pick up my child(ren). I understand that if I need someone other than the above individual(s) to pick up my child(ren), written notification must be submitted, prior to pick-up, to Yvonne Laschon, Faith Formation Assistant at ylaschon@stamericigh.com
- Agreed REQUIRED I Agree Please fill out this field.
- Email REQUIRED Please fill out this field. Please enter an email address.
Submit
- Faith Formation
  - For Children
    
    KIDs Club (Elementary CCE)
    
    Home Study
    First Sacraments
    Kids Club Contacts
    Pick-Up Consent Form
    
    Children's Liturgy of the Word
    VBS
    Volunteer for Faith Formation
  - For Youth
    
    CORE
    EDGE (MS Youth)
    LIFETEEN (HS Youth)
    BEYOND
    Gumbo Cookoff
    Summer Events
    Youth Ministry
  - For Adults
    
    FORMED
    R.C.I.A.
    Adult Bible Study
    Adult Confirmation
    Movie Night
    Safe Environment
  - Prayer & Spiritual
    
    Communal Prayer
    Lectio Divina
    Scripture Reflection
    Spiritual Direction
  - Sacrament Preparation