Child Pickup Authorization Template
School / daycare release form — the parent or guardian signs on the spot to confirm collection of a child. One device, no printing.
Use this free child pickup authorization template to create, fill in and sign a child pickup authorization online. Self-sign in your browser — tamper-evident audit trail included.
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CHILD PICKUP AUTHORIZATION
[school]
Date: [date] Time: [time]
Child
Child name: [child name] Class / Grade: [class]
Collected by
Name: [guardian name]
Relationship to child: [relationship]
ID verified (type / number): [id ref]
I confirm that I am authorized to collect the above-named child and that the child was released to me at the time stated. Released by staff: [staff name].