Authorized Pickup Form

Camper's Name*

First Name

Last Name

Parents/Guardians do not need to be added below. Please indicate any individuals aside from the camper's legal guardian(s) who you would like to be authorized to pick up the camper from TMC.

Authorized Pickup 1

First Name

Last Name

Authorized Pickup 2

First Name

Last Name

Authorized Pickup 3

First Name

Last Name

Authorized Pickup 4

First Name

Last Name

Authorized Pickup 5

First Name

Last Name

Authorized Pickup 6

First Name

Last Name

Authorized Pickup 7

First Name

Last Name

Authorized Pickup 8

First Name

Last Name

Sign below and click on "Submit Form" to complete this form

Signature*

[clear]

Use your mouse or finger to draw your signature above

Parent/Guardian Name*

First Name

Last Name