I authorize the following people to pick up my child from Lewinsville Montessori and understand that my child cannot and will not be release to anyone else (except emergency medical or civil personnel) without my expressed verbal or written permission:

The following people are not given authorization to pick up my child: (Appropriate paperwork such as custody papers shall be uploaded to this form if a parent is not allowed to pick the child)

Click or drag files to this area to upload. You can upload up to 10 files.
Please upload any documentation relating to custody or of persons not authorized for pickup.