Loading...

Editing previous response:

Please fix the highlighted areas below before submitting.

Pupil Data Sheet

Please complete the form below. Required fields marked with an asterisk *

Student Name

Sex*
Answer Required

Guardian #1

Guardian #2

Emergency Contact Information

Name of person(s) NOT  authorized to pick up your child:  

School Emergency Procedure

Your school has adopted the following procedures in caring for your child when he/she becomes sick or injured at school:

IN CASE OF EMERGENCY AND/OR NEED MEDICAL OR HOSPITAL CARE:

The school will call home.  IF there is no answer –

The school will call the father’s, mother’s, or guardian’s cell phone and/or place of employment.  IF there is no answer –

The school will call all other telephone number (s) listed.

If none of the above answer, the school will call an ambulance and/or paramedics, if necessary, to transport the child to a local medical facility.

The school will continue to call the parents or guardians until one is reached.