Emergency contact details

EMERGENCY CONTACTS:

Please give details below of persons who can be contacted in an emergency. Please note that we will always try to contact parents in the first instance.

IT IS ESSENTIAL THAT YOU PROVIDE THREE EMERGENCY CONTACTS INCLUDING PARENT/CARER(S)

Emergency contact 1

Name

Relationship to student

i.e. relative, friend

Email address

Contact number

Address

Telephone

Please specify whether home, work, fax or mobile

Emergency contact 2

Name

Relationship to student

i.e. relative, friend

Email address

Contact number

Address

Telephone

Please specify whether home, work, fax or mobile

Information on this form provided by:

Name/s

Date

Many thanks for your assistance in completing this form.

Signature

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