emergency contact form
WEECare
PRESCHOOL & KINDERGARTEN
EMERGENCY CONTACT FORM Child’s Name: ____________________________________________ In case of emergency, please list 3 persons (not including the child’s parents) we can contact or who are authorized to pick up your child if you are unable to be reached. 1. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________
2. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________
3. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________ Are there any individuals who ARE NOT AUTHORIZED to pick up your child? If so, please list them here: ____________________________________________________________________
Train up a child in the way he should go and when he is old, he will not depart from it. –PROVERBS 22:6 8901 Fall Creek Road Indianapolis, IN 46256
317-594-6968 FallCreekChurch.com
[email protected]
PRESCHOOL & KINDERGARTEN
EMERGENCY CONTACT FORM Child’s Name: ____________________________________________ In case of emergency, please list 3 persons (not including the child’s parents) we can contact or who are authorized to pick up your child if you are unable to be reached. 1. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________
2. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________
3. Name: __________________________________________________ Relationship to the child: ___________________________________ Cell phone: ______________________________________________ Alternate phone: __________________________________________ Are there any individuals who ARE NOT AUTHORIZED to pick up your child? If so, please list them here: ____________________________________________________________________
Train up a child in the way he should go and when he is old, he will not depart from it. –PROVERBS 22:6 8901 Fall Creek Road Indianapolis, IN 46256
317-594-6968 FallCreekChurch.com
[email protected]
