STUDENT Contact Information
Please enter the contact information we can use as the primary way to communicate with the parent/guardian of the child.
Parent / Guardian Contact Information
Please fill in all the areas that apply.
In the case of an emergency and a parent/guardian cannot be reached, please notify
This should be someone other than the parent/guardian(s) listed above.
Other Information that you would like us to know about your child
Please note: Only people with pick-up tags, or noted on this form will be allowed to pick up your child(ren) from Park Hills Church children's ministry events.
