Child Information Update

It is very important for our staff to have your most current contact information. Please complete this form if you have moved, changed phone number, changed work places, changed emergency contacts, changed persons who are authorized to pick up your child, allergy, medical conditions, medications, etc.

Information Update

If any of your contact information, address, parents work information, emergency information, etc has changed please complete.

Step 1 of 5 - Child's Information

Child's Name*
First Last
Address*
Street Address Address Line 2 City Postal Code
Home Phone Number*

Mother's Cell Phone*
Mother's Work Address
Street Address Address Line 2 City Postal Code
Mothers Email*

Fathers Cell Phone*
Father's Work Address
Street Address Address Line 2 City Postal Code
Father's Email*

Emergency Contact #1 Name*
First Last
Emergency Contact #1 Phone*
Emergency Contact #1 Address*
Street Address Address Line 2 City Province Postal Code
Emergency Contact #2 Name*
First Last
Emergency Contact #2 Phone*
Emergency Contact #2 Address*
Street Address Address Line 2 City Province Postal Code

Persons your child may be released to other than the mother and father*
Any changes in Allergies, Medical Conditions or Medcations since your last update?*
Are there any custody agreements or changes to existing agreements?*
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Child Information Update

Information Update

Step 1 of 5 - Child's Information

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