Permission to Release Form

  • The following people HAVE permission to pick-up the child named below from the CELC (Chabad Early Learning Center)

  • Child's Info

  • MM slash DD slash YYYY
  • Person 1

  • Person 2

  • Person 3

  • The following people MAY NOT pick-up my child(ren) from Chabad Early Learning Center

  • Note

    Any person unfamiliar to us may be required to show proof of identification. Please ensure that anyone whom you may send to pick up your child is included on this list. If at any time you want to add more people to the approved list, please use this form, or email info@chabadkidz.com. By signing this form, you agree that all of the information provided herein is correct.

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(123) 456-7890

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