Due to Data Privacy, we need to update information every year on every student at Campbell-Tintah Schools.  Synergy updates include who you want to have access to your child’s grades and student information.  SchoolReach updates are so we may communicate with a large group at one time; for instance, if there will be a late start or school closing due to inclement weather.  Cell phones seem to be a popular primary contact for a majority of our families and for various reasons these numbers are changed.  It is very important to keep the school informed of these changes.  We would also like to start using email as a way to keep families informed of what is happening at C-T on a daily basis.  The Daily Announcements have a week’s worth of information; games, field trips, music performances, and much more.  This is a great tool for parents too to keep in touch with teachers and teachers with the parents regarding students.  We will email under a blind copy so no one else can see your email address.

If there has been no change in Synergy access for your child(ren), please check mark the “No changes” box at the bottom of this page.

Primary Contact Phone Number (this is the primary number we will use for SchoolReach):

Name                                                                                                                    Phone Number

Secondary Contact Phone Number (this is a second number we can add to the SchoolReach database):

Name                                                                                                                    Phone Number

Email address:                                                                                                                                              

Adult’s allowed to have Synergy access:

Name                                                                Contact          Educational             Has                 Mailing

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Allowed              Rights               Custody           Allowed

                                                                             ☼                        ☼                       ☼                   ☼

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Contact          Educational             Has                 Mailing

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Allowed              Rights               Custody           Allowed

                                                                            ☼                        ☼                       ☼                   ☼

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Contact          Educational             Has                 Mailing

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Allowed              Rights               Custody           Allowed

                                                                            ☼                        ☼                       ☼                   ☼

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Contact          Educational             Has                 Mailing

⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀Allowed              Rights               Custody           Allowed

                                                                             ☼                        ☼                       ☼                   ☼

No changes, Synergy information is the same as last year.   ☼

Yes, I would like to receive via email the Daily Announcements & messages from teachers.  ☼

Dear Parents:

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 contact the school office with the new information.

Student                                                                         Birthdate                                   Grade

Parent/Guardian Information:

Mother                                                                          Father                                                              

Address                                                                                                                                               

Home Phone                                                                                                                                        

Cell Phone                                                                                                                                           

Work Phone                                                                                                                                         

Physician’s Name & Phone:                                                                                                                  

Dentist’s Name & Phone:                                                                                                                      

Please list any allergies or special needs your child(ren) may have:

Person(s) we will contact and will care for child(ren) in case a parent cannot be reached:

Name                                                                                        Phone                                                  

Name                                                                                        Phone                                                  

Parent permission to give Tylenol:                                                                     

In the event of inclement weather, SchoolReach will be prompted to call the Primary number listed on the other side of this form.  You may also listen to KBMW 1450 am for early dismissal.  Please have arrangements made in advance so young children have a safe place to go if a responsible person is not available to be at your home.  Please call the school immediately if your children are to be cared for at another home so we can get them on the correct bus and inform the bus drivers.  Thank you.