Student Pickup Form | Alfajrul Bassem

top of page

Use tab to navigate through the menu items.

Student Pick-up Form

Fill this form to inform us of who will be picking up your child/children

*If you are sending your child with their friend for the day, the form MUST be submitted by 3pm

Student Full Name

Parent Full Name

Name of Person Picking up your Child

I give permission for my child/children to go with the following person: *

Every Morning

Every Afternoon

Everyday Morning + Afternoon

Only Today

Select a date

I agree to send my child/children with the following person

Your Signature

Thanks for submitting!

bottom of page