EMERGENCY CONTACT (IN ADDITION TO PARENT OR CUSTODIAN)
PLEASE SELECT "YES" or "NO" TO THE FOLLOWING MEDICATIONS
PLEASE BE SURE TO UPDATE ANY OR ALL INFORMATION ON THIS FORM IF ANYTHING CHANGES. THIS INCLUDES:
IF MEDICATIONS ARE TAKEN ON A REGULAR BASIS, FILL OUT THE SECTION BELOW (INCLUDE INHALERS):
IF MEDICATIONS ARE TAKEN ON AN AS NEEDED BASIS, FILL OUT THE SECTION BELOW:
⭐ REQUIRED INFO--PLEASE FILL OUT COMPLETELY ⭐
If your child has a severe allergy or seasonal allergies that might require the need of an epi-pen or medication(s) to treat symptoms, please send epi-pen or medication(s) with your child.
If you have any questions or problems completing this form, please let us know at firstname.lastname@example.org!
Please consider making a monetary donation to the Home and School Association.
Your involvement and financial commitment will enable us to reach our goals this year.Please feel free to email us with any questions or ideas you may have: email@example.com