<p> STUDENT AUTHORIZATION/RELEASE</p><p>AUTHORIZATION FOR PICK UP</p><p>The University of Alaska Protection of Minors on Campus policy requires that students be signed out every day from __(Program Name)______. Please provide the names of people authorized to sign out and pick up your child.</p><p>1.______2.______</p><p>3. ______4.______</p><p>AUTHORIZATION TO WALK/BIKE HOME</p><p>___Yes, my child has permission to leave _____(Program Name)______and walk/bike home without adult supervision. I understand that UAF and (Program Name) staff are not responsible for my child’s safety after he/she leaves. Walkers/bikers will not be allowed to leave until (0:00 time), when the program has ended.</p><p>___No, my child does not have permission to walk/bike home.</p><p>Parent/Guardian Signature______Date______</p>