Kidz on the Ridge Child Pick Up Authorization Form 2026

Welcome to the Child Pickup Authorization Page!

Please read the text below and fill out the Child Pick up Authorization form if you wish to allow someone other than parents/guardians to pick up your children. The member number used on this form must match the member number used on the pre-registration form.

I hereby inform Kidz on the Ridge that the people listed below are authorized to pick up the below named child/ren at any time. Accordingly, Kidz on the Ridge is hereby instructed to release my child/ren into the care of the following people whenever they come to pick up their child/ren. AUTHORIZED PICK-UP PERSON (must be a minimum of 18 years old unless special written arrangements are made).

I understand that: Parents/guardians must inform Kidz on the Ridge when the name of the person listed below will pick up their child/ren. This applies when the child’s normal pickup routine varies. Any person that picks up your child/ren may be asked to provide a photo ID to the staff if they are not familiar with the person on the below list. This document shall remain valid until edited or rescinded in writing by the parent/guardian.

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Up Pick Authorization

Member Number *

Name of Family *

Pick Up Authorization Approved Name 1 *

First

Last

Pick Up Authorization Approved 1 Relationship to child/ren *

Pick Up Authorization Approved 1 Phone Number *

Pick Up Authorization Approved Name 2

First

Last

Pick Up Authorization Approved 2 Relationship to child/ren

Pick up Authorization Approved 2 Phone Number

Pick Up Authorization Approved Name 3

First

Last

Pick Up Authorization Approved 3 Relationship to child/ren

Pick Up Authorization Approved 3 Phone Number

Parent/Guardian Authorization *

First

Last

Submit