I, , hereby authorize Totz 'N' Teenz on Wheelz to pick up and/or drop off my child(ren) , , , , at (location) from (date) to (date) or indefinitely until I rescind this authorization in writing.
Parent/Authorized Signature: Date:
Please complete this form, print and remit to the location that your child will be picked up from.
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Totz 'N' Teenz on Wheelz strong> 1925 Rothmullan Drive Charlotte, NC 28262 (980) 219‐7020 office (704) 309‐0262 mobile