| Contact Information Child's Name: ________________________________________________ Home phone number: ___________________________ Mother's name: ______________________________________________ Mother's occupation: _____________________________________________________ Mother's place of employment: ________________________________________________________________ Mother's work phone number: ___________________________________ Mother's cell phone number: ____________________________________ Mother's E-mail address: _________________________________________ Father's name:________________________________________________ Father's occupation: _________________________________________________ Father's place of employment: ____________________________________________________________________ Father's work phone number: _____________________________ Father's cell phone number: _______________________________ Father's E-mail address: ___________________________________ Emergency contact name: _____________________________________ Emergency contact phone number: ________________________________ Emergency contacts relationship to child: ______________________________ Other than you, who has permission to pick up your child? Any person not listed will not be allowed access to your child. Anyone other than parents will be required to show photo indentifiacation at pick up. Name: _______________________________________________ Phone Number: _____________________________________ Relationship_________________________________________ Name:______________________________________________ Phone Number: _____________________________________ Relationship________________________________________ Name: ___________________________________________ Phone Number:___________________________________ Relationship________________________________________ |
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