Rea Farms Parent Information
Parents - this is an alternative method for completing our standard "blue" sheet.  It asks you for contact information as well as important information we need to know about your child.  We have also included recognition of several of the forms that go home at the start of the school year.  Thank you for providing this very important information.
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Student Last Name *
Student First and Middle Name *
Parent 1 First and Last Name
Parent 1 Email Address
Parent 1 Phone Number
Parent 2 First and Last Name
Parent 2 Email Address
Parent 2 Phone Number
Additional Home Phone Number(s)
Student Home Address *
Homeroom Teacher *
Grade Level *
Student Birth Date *
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DD
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In Case of an Emergency, please contact (provide name and contact number) *
Are there custody issues the school needs to be aware of? *
The following person is authorized to Pick-Up Student from School (Include name, relationship, and phone number) *
The following person is authorized to Pick-Up Student from School (Include name, relationship, and phone number)
The following person is authorized to Pick-Up Student from School (Include name, relationship, and phone number)
The following person is authorized to Pick-Up Student from School (Include name, relationship, and phone number)
The following person is authorized to Pick-Up Student from School (Include name, relationship, and phone number)
If my child is in an accident or becomes sick and cannot remain in school, I understand that the parent/guardian will be notified immediately. If they cannot be contacted, the neighbor or friend listed on this card will be contacted. If the accident or illness is not an emergency and emergency contacts are unable to pick up the child then he/she will remain at school until the parent/guardian can be contacted. I further understand that if the child is too ill to ride the bus the parent must make arrangements to get the child home. In the event that it becomes apparent that the child needs immediate medical attention and the parents or emergency contact cannot be reached, the school principal (or designee) has my permission to send the child to an emergency room by EMS. I understand that I will bear the financial responsibility for transportation and treatment. Medical information may be shared with school personnel who need to know in order to provide for the health and care of my child. Entering your name below is in lieu of a signature. *
Thank you!Thank you for completing this information for your child.  Please remember that this form is an alternative to the paper documents and you do not need to complete a paper and electronic copy.  
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