NOTE: Please be advised that CCDN will require a copy of the insurance card on file for emergency purposes.
NOTE: Any persons designated as an emergency contact or pick up person will be required to show identification prior to picking up the youth. Parents, please be sure to let them know A phone call is REQUIRED if there are any changes in pickup person.
I certify that I am a parent/legal guardian of the youth listed in this application. I give permission for the youth listed in this application to participate in Community Care Development Network programs, services, and sponsored events and activities. I have read and understood all of the releases above: