Emergency Contacts

What is your name? *
What is your address *
What is your postcode *
What is your home phone number *
What is your e-mail address (this is our main way of contacting you) *
Are the emergency contact numbers applicable to all children if you have more than one in the club? If no please complete a separate form for the others. *	Yes No
The Club is required by the ASA to have 2 emergency contacts. We always have a list at the desk and at least one teacher has a list. The 1st one is? *
The relationship is? e.g Mum/Nan/Friend *
The 2nd contact number *
The relationship is? e.g Mum/Nan/Friend *
1st child's name *
Any allergies e.g asthma, diabetic etc *
2nd child's name
Any allergies e.g asthma, diabetic etc
3rd child's name
Any allergies e.g asthma, diabetic etc
4th child's name
Any allergies e.g asthma, diabetic etc