Fillable Form 1: ne form must be filled out (City of Westminster)

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Form 1: ne form must be filled out (City of Westminster)

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The Form 1: ne form must be filled out (City of Westminster) form is 1 page long and contains:

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Country of origin: US
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U.S.A. forms for City of Westminster

BROWSE CITY OF WESTMINSTER (MD) FORMS

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O
ne form must be filled out for each child enrolled in camp. Please list all people authorized to pick
up your child(ren) from camp including yourself. Valid photo identification will be requested when
picking your child(ren) up from camp. This form can be updated throughout the camp season.
Name of child:_________________________________________________________________________
1
. D
esignated Guardian:_________________________________________________________________
Relationship to child:_____________________________________________________ Male/Female
2
. D
esignated Guardian:_________________________________________________________________
Relationship to child:_____________________________________________________ Male/Female
3. Designated Guardian:_________________________________________________________________
Relationship to child:_____________________________________________________ Male/Female
4
. D
esignated Guardian:_________________________________________________________________
Relationship to child:_____________________________________________________ Male/Female
5
. D
esignated Guardian:_________________________________________________________________
Relationship to child:_____________________________________________________ Male/Female
Any custody restrictions we should be aware of? Yes
No
If yes, please explain:
Signed by Parent/Legal Guardian:______________________________________________________
Printed Name:__
_______________________________________Date:_______________________
City of Westminster Recreation & Parks
Summer Camp
Authorized Pick Up Form
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Form 1: ne form must be filled out (City of Westminster)

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Completed 17 July 2020

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