Child information

Parent / guardian information

Add each parent or legal guardian. Use “Add another parent/guardian” for a second parent or additional guardians.

Emergency contacts

Include at least one contact. Add more as needed. Check “Out-of-area / out-of-state” when applicable (as on the paper form’s third emergency line).

Medical information

Pickup authorization & signatures

List everyone allowed to pick up your child. You may include emergency contacts here if they are also authorized for pickup.