Request to Add Emergency Contact Form
In the event of an emergency, parents/legal guardians will always be contacted first. If unreachable, we will reach out to additional emergency contacts.
Your Name
*
First Name
Last Name
Number of student(s) attending Discovery Falcon with this new emergency contact
*
Student 1
First Name
Last Name
Student 2
First Name
Last Name
Student 3
First Name
Last Name
Student 4
First Name
Last Name
New Emergency Contact Information
Full Name
*
First Name
Last Name
Gender
*
Please Select
Female
Male
Non-Binary
Relationship to Student
*
Please Select
Aunt
Brother
Father
Friend
Grandfather
Grandmother
Mother
Neighbor
Other
Parent
Stepparent
Sister
Uncle
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I hereby acknowledge the above-stated person has permission to pick up my child(ren) listed above.
Your Signature
*
Submit
Should be Empty: