Event Registration

Parent Proxy Form 2025 - 2026

Description:

Fill out this form to allow an authorized adult to drop off, pick-up, or care for your kids on campus while you are away.

Free Event

Start Time: 9:00 am
End Time: 5:00 pm

Start Date: September 1, 2025
End Date: August 31, 2026

Student Information

Student First Name*

Student Last Name*

Parent/Guardian Email*

Student Birthdate (mm/dd/yyyy)*

Student Grade (if student were enrolled in traditional school)*

Gender:

Student Email Address

Parent Proxy Authorization

As parent or legal guardian of the below-named child(ren), I appoint the following person to be a Parent Proxy responsible for my child(ren) during all or part of the Compass Homeschool Enrichment program when I leave the campus. By listing the proxy below, I have obtained his/her permission and agreement to accept this responsibility. Please list only one adult per proxy form. For additional authorized adults, please submit a separate Proxy Form.

Parent Proxy Full Name*

Proxy Cell Phone*

Proxy Email Address*

The Parent Proxy has my permission to:*

Drive child(ren) to/from the program
Sign child(ren) in/ out each day
Supervise child(ren) in the common areas before between or after classes
Authorize emergency medical treatment

Other granted permission (specify):

These responsibilities are appointed to the Parent Proxy in my absence for:*

Full Year
Specific Dates

Specific dates for Parent Proxy:

Parent Signature:
By providing the name and contact information of the indicated Parent Proxy adult, you have obtained this individual’s authorization to serve as your proxy. You take full responsibility for notifying your proxy every time you need him/her to serve in the capacity(ies) noted on the form.*

By clicking this box I am digitally signing this form.

Credit/Discount code:

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