Please provide AT LEAST TWO authorized contacts with different phone numbers and addresses, in addition to the parent contact numbers. Authorized contacts and the local authorities can be contacted when parents are not available.
Name of Person to call in case of an emergency if parent/guardian cannot be reached:
First Emergency Contact
Second Emergency Contact
Additional Authorized pick-up persons:
1st Pick-Up Person
2nd Pick-Up Person
3rd Pick-Up Person
In the event that I cannot be reached to make arrangements for emergency medical attention, I authorize the director to take my child to the nearest emergency clinic, call the doctor listed below, and/or call for an ambulance.
- Tuition Payments are to be made by the second class meeting, unless other arrangements have been made with the director (a separate form must be filled out outlining said arrangement).
- I understand that if I get behind on my payments, it can cause my child to be dropped from the program. Reinstatement will be granted once my outstanding balance is brought up to date.