Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
ARE THERE CUSTODY CONCERNS INVOLVING YOUR CHILD OF WHICH WE SHOULD BE AWARE?
Yes _______ No _______
LIST ANY PERSON NOT ALLOWED TO SEE YOUR CHILD OR CHECK YOUR CHILD OUT OF
SCHOOL
PERSONS TO CALL WHEN PARENTS CANNOT BE REACHED. LIST SOMEONE WITH A PHONE.
NAME ______________________________________ PHONE # _____________________
RELATION ________
NAME ______________________________________ PHONE # _____________________
RELATION ________
IF YOU CANNOT BE REACHED AND YOUR CHILD SHOULD NEED EMERGENCY TREATMENT BY A
PHYSICIAN OR HOSPITAL ATTENDANT, DO YOU GIVE PERMISSION FOR HIM/HER TO RECEIVE
MEDICAL ATTENTION? YES ________ NO _______
DOES YOUR CHILD TAKE ANY MEDICATION ON A REGULAR BASIS? YES _______ NO _______
IF YES, PLEASE EXPLAIN AND GIVE ANY SPECIAL INSTRUCTIONS: ______________________
___________________________________________________________________________________________
LIST ANY INFORMATION WE NEED TO KNOW ABOUT YOUR CHILD (PHYSICAL/ MEDICAL
PROBLEMS, SUSPENSION, PROBATION, CUSTODY PROBLEMS, ETC…)
___________________________________________________________________________________________
___________________________________________________________________________________________