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JCA Parent Contact Information
Please complete all sections
Parent #1 Name *
Relationship to Student? *
Parent #1 E-mail Address *
Phone #
Parent #2 Name
Relationship to Student? *
Parent #2 E-mail Address
Phone Number
Current Address *
Student #1 Name *
Student #1 Grade *
Student #2 Name
Student #2 Grade
Student #3 Name (Type N/A if this does not apply) *
Student #3 Grade
Student #4 Name
Student #4 Grade
Student #5 Name
Student #5 Grade
Student #6 Name
Student #6 Grade
List any relatives I should contact in case I cannot locate the parents.  (Name, Relationship, Phone Number).  This list of people can pick up your child in case of an emergency.
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