BMS Student Emergency Contact Updates 2020-2021 (Grades 6-8)

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It is important that BMS have the most up-to-date family & emergency contact information for your student. Please complete this form. There is an "Other Notes" section at the end of the survey for any additional information you feel is important for us to know. Thank you and we are looking forward to the new school year!
**You may complete one form for all of your BMS students or fill out this form multiple times if the information is different for each of your BMS students.**

Student Name(s) (First & Last!) *

Student's Address *

Primary Contact's Email Address *

Primary Contact's First & Last Name *

Primary Contact's Address *

Primary Contact's Phone Number (include area code) *

Primary Contact's Alternate Phone Number (include area code)

Primary Contact's Relationship to Student *

Secondary Contact's Email Address (if parent or guardian)

Should the Secondary Contact's email address be used for communication from school regarding your student(s)?

Yes

Secondary Contact's First & Last Name *

Secondary Contact's Address (only complete if a parent or guardian)

Secondary Contact's Phone Number (include area code) *

Secondary Contact's Alternate Phone Number (include area code)

Secondary Contact's Relationship to Student *

Priority 3 Contact's First & Last Name

Priority 3 Contact's Phone Number (include area code)

Priority 3 Contact's Alternate Phone Number (include area code)

Priority 3 Contact's Relationship to Student

Dear Parents/guardians, It is important that you screen your child for temperature, other symptoms, and risk factors for COVID-19 each day before sending them on the bus or into the building. If the student has any signs of illness or risk factors, they will remain at home and the parent/guardian will contact the school nurse. Barrington Public Schools requires you to use the Student attestation form daily to screen your child. We will send out weekly reminders on Sunday evenings with reminders about how to screen for symptoms of and risk factors for COVID-19 and what would necessitate your child to stay home. Link to Student Screening Protocols: https://docs.google.com/document/d/175-uIYEtECjeSqNdJmH-KsOP3GtCo9CHCIEDzb0f9hU/edit?usp=sharing *

I acknowledge that I am required to screen my child each morning using the linked form, and I agree to not send them to school if they evidence any of the symptoms on the form. I will call the school nurse and remain in close communication. If my child is able to engage in learning, they will log on Canvas and Zoom according to the directions provided by the teacher.

Required

There are times throughout the year when your child's picture may be taken. Some of these pictures will be displayed publicly (ie newspaper, school's public website, official social media) and some will be displayed privately (ie teacher website, yearbook). We understand that not everyone wishes to have their child's picture displayed in public view. If you DO NOT wish to have your child's picture shared publicly, please type your name below.

Any other items you would like us to know!

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