Please carefully read & submit the following for emergency contact information for your child:

CHILD CARE EMERGENCY CONTACT INFORMATION

  • MM slash DD slash YYYY
  • Emergency Contacts

    Person to contact when attempts to reach parents are not successful.
  • Persons (Other Than Parent/Guardian) Authorized to Pick Up the Child

    We must have written permission for anyone other than parent/ guardian to pick child up from the center.
  • Child's Medical Emergency Contact

  • Child's Health Insurance

  • Parent/Legal Guardian Consent and Agreement for Emergencies

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY