EmailMe Form - Early Pick Up

Date and Approx. Time for Early Picked Up *
MM / DD / YYYY HH : MM AM/PM
Child's Name *
First Last
Other Children in Family Being Picked Up
First Last
Other Children in Family Being Picked Up
First Last
Name of Person Picking Up the Child *
First Last
Relationship to Child *
Parent/Guardian Signature *
First Last
By typing in your name and submitting this form, you are giving permission for your child to leave early from ARK and to be picked up by the above person listed.