Pre-School Transportation-Health-No Contact Verification Form

Who do allow to transport your child?

Name of Student Enrolling*
First Last
Approved Contact List to Transport
Please List the Contacts of Individuals ALLOWED to pick-up your child from Pre-School
Name of (First Contact)*
First Last
Phone Number of FIRST contact*
Relation Ship of FIRST Contact*
Name of SECOND Contact
First Last
Phone Number of SECOND contact
Relation Ship of SECOND Contact*
Name of THIRD Contact
First Last
Phone Number of THIRD contact
Relation Ship of THIRD Contact*
HEALTH CONTACT INFORMATION
List Names, Phone Numbers and Relationship to Child*
If a parent/guardian is unable to be contacted by the Trojan Tots staff, I allow the following people to discuss my child’s immediate health concerns:
NO CONTACT to my child
Please List Names/Relationship of all individuals not allow to have contact with my child
The district will take every attempt to contact the legal guardian to inform them when a person asks to take a child from school. Parents should provide the school with any and all court ordered documentation (Divorce Decree-Custody Determination-All other legal documents disclosing custody of the child)

Approved Contact List to Transport