HEARTS OF OHIO - State - Pickup Information

Pickup Information

For Hearts of Ohio 2026
PICKUP CONTACT INFO - Due Sunday, May 31, 2026

For the safety of your daughter, they may be picked up ONLY by those individuals specified by you in writing on this authorization release form. All authorized persons must present a photo ID or other valid identification upon request by our Miss Ohio staff.

Hearts of Ohio will be wearing photo ID badges. You may designate yourself and two other people authorized to pick up your daughter. Submit the info below (name, phone number, and photo), and it will appear on the back of the photo ID badge.

In an emergency, if no pre-authorized people are available to pick up your daughter, please contact Gianna at 567-241-2372 with the name of the person who will pick up your daughter. Gianna will call you back to confirm the temporary pickup person's information.
Heart of Ohio Name
The following perosn will normally drop off and pick-up my Daughter.
Primary Person Name
Primary Person Mobile Phone
Photo of Primary Person

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I hereby authorize the following persons(s) to pick up my daughter when necessary:
Alternate Person 1 Name
Alternate Person 1 Mobile Phone
Photo of Alternate 1 Person

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Alternate Person 2 Name
Alternate Person 2 Mobile Phone
Photo of Alternate 2 Person

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Additional Info or Comments
You are welcome to submit any additional information or comments.
Submitted By Name
Name of the person submitting this form.
Submitted By Email
A copy of this form will be emailed to this E-mail Address
Should be Empty: