SBMS EMERGENCY CONTACT INFORMATION

Student First Name

Student Last Name

Grade

Primary Contact
Primary contact information is where the child lives. Primary contacts will be notified first for all concerns/emergencies. Please provide first and last names of primary caregivers, address and all telephone numbers.

Primary Contact's Name(s)

Primary Contact Relationship(s) to Student

Home Phone Number

1st Cell Number

2nd Cell Number

1st Work Number

2nd Work Number

1st Email Address

2nd Email Address

Comments:

Have you updated the contact information on your Realtime Parent Portal?

Yes

Don't know how to.

1st Emergency Contact
Emergency contacts listed will be called to pick your child up if primary contacts cannot be reached. Your child cannot be released to anyone not listed unless the office is notified. *If emergency contact is a non-custodial parent, please provide an address for school mailings.*

1st Emergency Contact's Name(s)

1st Emergency Contact's Relationship(s) to Student

Home Phone Number

1st Cell Number

2nd Cell Number

1st Work Number

2nd Work Number

1st Email Address

2nd Email Address

Comments:

2nd Emergency Contact
Emergency contacts listed will be called to pick your child up if primary contacts cannot be reached. Your child cannot be released to anyone not listed unless the office is notified. *If emergency contact is a non-custodial parent, please provide an address for school mailings.*

2nd Emergency Contact's Name(s)

2nd Emergency Contact's Relationship(s) to Student

Home Phone Number

1st Cell Number

2nd Cell Number

1st Work Number

2nd Work Number

1st Email Address

2nd Email Address

Comments:

*PLEASE NOTIFY THE MAIN OFFICE ASAP WITH ANY FUTURE CHANGES TO EMERGENCY CONTACT INFORMATION*