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Camper Pick Up Permission Form

Camper’s Name

Date of Camp

Please list everyone who is authorized to pick your child up from camp. Please inform the camp instructor in the morning or email the Family Education Coordinator if there are any changes in who is authorized to pick your child up.

Name of authorized person Primary Phone Number Secondary Phone Number

Parent or Guardian’s Name

Home Ph. Work Ph. Cell Ph.

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Camper Pick Up Permission Form

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