Emergency Contact Form

YELLOW EMERGENCY FORM or WHITE CARD REMINDER:

Submit Emergency Form/Card to the Health Office EACH School Year
Students will ONLY be released from the Health Office to the Adults listed on the Emergency Form/Card
Photo Identification MUST be presented before the Student will be released
If a student is NOT to be released to a non-custodial parent, list the NAME in the designated area.

(Papers must be filed with the school)

Provide an updated Health History
Must be SIGNED and dated in INK by the Parent/Guardian to be valid
Please feel free to contact the health office and confirm the form/card has been received (many students forget to hand them in).