Transportation/Emergency Information

Childs Name:_______________________________
Parents names: _________________________________________________________ Preferred email(s):
(to be contacted/receive
Family address(es): _________________________________________________________________
newsletters)

Family phone #s (work/home): ___________________________________________________________________

___mom: _
____________________
Dad: _
_______________________

My child gets to school by: (check which one applies)

Other: _
_____________________

____bus (bus number: ____)

____car

*How will your child get home

on the first day of school?*

____walks

____bus (bus number: ____)

My child gets home by:
____bus (bus number: ____)

____car
____walks

____car

____goes to y-care (@ ive)

____walks

____goes to daycare (bus

number: ____)

____goes to y-care (@ ive)

____goes to daycare (bus number: ____)

Name and phone number of the daycare is: _______________________________________

In case of an early release dau due to bad weather, my child is to go home:
____same way as listed above
____a different way (please specify) _____________________________________________________________
Phone numbers of closest relative or emergency contact:
1.

_____________________________________________________________

2. _
_____________________________________________________________
Parent signature: ____________________________________ date: ____________________________________
Please notify me of any changes in the emergency information above.

I want your

child to get home safely and cannot allow your child to go a different way home
other than what is listed above unless you notify me.

Thank you!