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Emergency Contacts Primary Contact: _____________________________________________ Relationship:   Parent    Custodial Guardian Primary Phone Number(s): ______________________________________ Secondary Contact:____________________________________________ (In case Primary Contact cannot be reached) Secondary Contact Phone Number(s): _________________________________ Cell Phone/Secondary Phone:__________________________________ In the event that the parent/guardian cannot pick up your child, please provide a list of people that you give permission to pick up your child: ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________

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Emergency Contacts Form

  • 1. Emergency Contacts Primary Contact: _____________________________________________ Relationship: Parent Custodial Guardian Primary Phone Number(s): ______________________________________ Secondary Contact:____________________________________________ (In case Primary Contact cannot be reached) Secondary Contact Phone Number(s): _________________________________ Cell Phone/Secondary Phone:__________________________________ In the event that the parent/guardian cannot pick up your child, please provide a list of people that you give permission to pick up your child: ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________ ________________________________________Relationship:___________