Include the names and phone numbers of two contacts other than parents. These people will be contacted if the parents/guardians cannot be reached.
Emergency Contact 1 *
Your answer
Phone *
Your answer
Relationship *
Your answer
Emergency Contact 2 *
Your answer
Phone *
Your answer
Relationship *
Your answer
Other information
Siblings (include names,ages, & teacher if South Mebane student)
Your answer
Allergies/Health Concerns
Your answer
List any holidays not observed
Your answer
What would you like for me to know about your child? *
Your answer
Transportation
Please complete transportation information (walker, car, Third Street After School Care, Bus number, etc.). If transportation ever changes, please send a note or call the office. Thanks.
Arrival to School *
Your answer
Departure on FIRST DAY *
Your answer
Departure after first day *
Your answer
Form completed by: *
Your answer
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