Cross of Life Christian Montessori School
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                                                                          EMERGENCY CONTACT INFORMATION


                                                                          Please list all the ways we can get in touch with you while your child is at school, and one other emergency contact that will be available.  We must be able to reach one of the parents or emergency contact at all times.  If you will be out of town, please let your child’s teacher and the office know who is to be contacted by writing a note or sending an email in advance of your departure.

                                                                          Child’s Name _________________________________                   Birthday____________________


                                                                          School Year 20____ - 20____

                                                                          MOM: Name:__________________________________

                                                                          Cell____________________________________

                                                                          Work_______________________________________

                                                                          Home________________________
                                                                          ___________________

                                                                          Other#__________________________________________

                                                                          Other#__________________________________________

                                                                          DAD: Name: __________________________________

                                                                          Cell_____________________________________

                                                                          Work____________________________________

                                                                          Home ___________________________

                                                                          Other #______________________________________

                                                                          Other#_____________________________________________

                                                                          OTHER CONTACT:

                                                                          Name________________________________    Relationship to child___________________________

                                                                          Cell___________________

                                                                          Home_________________

                                                                          Work__________________

                                                                          Other#____________________