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Student Pick-Up Release Form

Please provide at least two individuals with whom Cambridge Classical Academy is authorized to release your child. Required fields marked with an asterisk *

Student First Name*

Answer Required

Student Last Name*

Answer Required

Grade*

Answer Required

Parent/Guardian Information

Parent/Guardian 1 Name*

Answer Required

Parent/Guardian 1 Phone*

Number Required

Parent/Guardian 1 Email*

Answer Required

Parent/Guardian 2 Name

Answer Required

Parent/Guardian 2 Email

Answer Required

Parent/Guardian 2 Phone

Number Required

Authorized Release Contact Information

First Name*

Answer Required

Last Name*

Answer Required

Work Phone*

Number Required

Relation to Student*

Answer Required

Additional Authorized Release Contact Information

First Name*

Answer Required

Last Name*

Answer Required

Phone*

Number Required

Relation to Student*

Answer Required

Additional Authorized Contact Information

First Name

Answer Required

Last Name

Answer Required

Email 2

Answer Required

Phone

Number Required

Relation to Student

Answer Required

Confirmation Email

Confirmation Email *

Email Required