HomeForms Forms Emergency Contact & ALTERNATIVE PickUp This form is for the child(ren) *In an emergency, Latitude will call the individuals on this form. Please provide your contact information, as well as anyone else who can be notified in case of an emergency.Name of parent or guardian filling out form *Parent Primary Phone *Parent Alternate PhoneParent Email *Email of the person filling out this formEmergency ContactsPrimary Emergency Contact Name *Primary Emergency Contact Phone *Primary Emergency Contact Phone Alt PhoneRelationship to Child (Primary Emergency Contact)Secondary Emergency Contact NameSecondary Emergency Contact NameSecondary Emergency Contact Phone Alt PhoneRelationship to Child (Secondary Emergency Contact)Third Emergency Contact NameThird Emergency Contact PhoneThird Emergency Contact Phone Alt PhoneRelationship to Child (Third Emergency Contact)Approved Adults for Student PickupPickup Name (first)Email Address of PickupPickup main phonePickup main phoneRelationship to Child (Pickup person)Pickup Name (second)Email Address of PickupPickup alt phonePickup alt phoneRelationship to Child (Pickup person)I confirm my students Emergency Contacts & Alternate Pickup Share this:TwitterFacebookLike this:Like Loading...
