Emergency Contact Form

Dear DGK Family,

In order to be sure that you receive our automated school notification calls concerning school closings and other important messages, we are currently updating our student/family and emergency contact records again. Please review the following information below and make any necessary corrections/changes/additions. Kindly return this form to your child’s teacher. Thank you for your prompt attention to this matter.


Student's Name *
Student's Name
Birth Date *
Birth Date
Address *
Address
Mother's Name
Mother's Name
Father's Name
Father's Name
Home Phone *
Home Phone
Mother's Cell Phone
Mother's Cell Phone
Father's Cell Phone
Father's Cell Phone
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
Doctor's Name *
Doctor's Name
Doctor's Phone *
Doctor's Phone
Has our school nurse been notified?
Is student able to participate in physical activities?

If we are unable to reach you in the event of an emergency we will contact your provided information.

It is understood that in the final disposition of an emergency, the judgment of the school authorities will prevail and the recommendation of the parent as indicated above will be respected as far as possible.