Family Emergency Contact
Please complete and return to school as soon as possible. It is very important to keep our records up-to-date and provides us with the proper procedure you wish us to take if emergency care is needed for your child(ren). If any changes occur during the course of the school year, please call the school office with new information.
Home Phone____________________________ ___________________________________
Work Phone______________________________ _________________________________________
Cell Phone__________________________ ________________________________________
Physician’s Name & Phone_________________________________________________________________
Dentist’s Name & Phone___________________________________________________________________
Please list any allergies or special needs your child(ren) may have which we are not aware:
Person(s) who will care for child(ren) in case a parent cannot be reached:
**Parent permission to give Tylenol:
In the event of bad weather, listen to KBMW – 1450 AM for early dismissal and have arrangements made for young children to have a safe place to go if a responsible person will not be available at your home. Please call the school immediately if your children are to be cared for at another home so we can inform the bus drivers. Thank you.
THE CAMPBELL-TINTAH SCHOOL DISTRICT DOES NOT DISCRIMINATE ON
THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, AGE OR DISABILITY.
“AN EQUAL OPPORTUNITY EMPLOYER”