Name of Parent(s)/Guardian(s)* Parent's email* Other parent's email Parent's Cell Phone (XXX-XXX-XXXX)* Other Parent's Cell Phone (XXX-XXX-XXXX) Child 1 Name Child 1 Birthday (YYYY-MM-DD) Child 1 Grade Child 2 Name Child 2 Birthday (YYYY-MM-DD) Child 2 Grade Child 3 Name Child 3 Birthday (YYYY-MM-DD) Child 3 Grade Child 4 Name Child 4 Birthday (YYYY-MM-DD) Child 4 Grade Emergency Information Emergency contact person in event parents cannot be reached: Name Phone (XXX-XXX-XXXX) Relationship to child/family Medical Allergies Media We periodically take pictures and video for use online or in public places. We never print anyone names without written consent.