Emergency Cards 2021-2022

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Dear Parents, Every year Mrs. Epplin has you fill out a new emergency card at registration. This year we did registration online and with the Covid restrictions, we had minimal contact. Please fill out following form so that we will be able to create Emergency Cards for your children to have on hand if needed. Thanks so much!

List Name's of children and birthdays: example John Smith 1-21-2001 Sally Smith 1-3-2000

Father’s name and business phone:

Father’s cell phone:

Mother’s name and business phone:

Mother’s cell phone:

Home Address:

Father’s email:

Mother’s email:

In case of emergency call: (name and phone#)

Allergies or other medical problems: Please type name of student and issue.

Step Parent or other Guardian phone: Name , relation and phone

Any other information you think we should know in case of an emergency

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