Emergency and Consent Form

  • Emergency and Consent Form

  • Parents or Guardians who can be reached during the day:

  • Parent/Guardian #1 Information

  • Parent/Guardian #2 Information

  • EMERGENCY CONTACTS & AUTHORIZED PICK-UP- Must be someone other than a parent or guardian

    Please list at least 3 emergency contacts other than the parents or guardian. The following people have permission to pick up your child in case of an emergency.

  • NAMEPHONERELATIONSHIP 
  • NAMEPHONERELATIONSHIP 
  • NAMEPHONERELATIONSHIP 
  • NAMEPHONERELATIONSHIP 
  • NAMEBIRTHDATEGENDER 
    Add a new row

    CLICK ⊕ ICON TO ADD MORE...