In case of an emergency, it is critical that someone besides yourself who we are authorized to contact AND who may pick up your child. By law, our organization may NOT release your child to someone who is not a legal guardian UNLESS you have given prior written authorization to do so. By providing emergency contact information, you are granting that consent to the following individual(s).

Please indicate any known allergies your child has and provide your electronic signature where prompted.

Please indicate any medications your child is taking and provide your electronic signature where prompted.