Transportation Authorization Form

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.

Thank you for registering with us!

Totz 'N' Teenz on Wheelz
1925 Rothmullan Drive
Charlotte, NC 28262
(980) 219‐7020 office
(704) 309‐0262 mobile