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2022-2023 Class Contact Information
Student / Parent contact information for the emergency safety binder
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Email
*
Your email
Student Information
Student Frist name
Your answer
Student last name.
*
Your answer
Does your child have any allergies.
Your answer
Is there anything that you want us to know about your child.
Your answer
Parent Information
Name of Parent 1
*
Your answer
Phone Number of Parent 1
*
Your answer
Email of Parent 1
*
Your answer
Mailing address of Parent 1
Street
Your answer
City
Your answer
State
Your answer
zip code
Your answer
Name of Parent 2
*
Your answer
Phone number of Parent 2
*
Your answer
Email of Parent 2
*
Your answer
Mailing address of Parent 2
Street
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Name of an emergency contact person.
*
Your answer
Phone number of emergency contact person.
*
Your answer
Thank you! If this information changes, please let us know.
A copy of your responses will be emailed to the address you provided.
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