Child's Details:
Parent/Legal Guardian Details:
Emergency/Pick Up Contact Details:
Persons other than parents/legal guardians that are allowed to pick up your child in case of emergency or incase parents/legal guardians are unable to pick up their child. Please provide us with at LEAST ONE contact. If you require more space for additional pick up persons please ask adminitration team for an additional contacts form.*Parents/legal guardians must notify educators if someone other than themselves will be picking up their child even if they are listed on this form.
Court Orders: Please provide administration team with copies of any court orders that may restrict contact, specify parental guardianship, or pertain to your child.
Child's Medical Information: