Information Change Form

Information Change FORM

*For current students only.

The form below is used to update a new address, phone number, email etc.

For any new authorized individuals having permission to pick up your child(ren),

we need a written authorized letter from the parent/guardian including their wet signature.

Child's Name

First Name

Last Name

Child's Birthdate

Information Change:

Effective Date

MM

DD

YYYY

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Phone Number