MUSICAL THEATRE: Emergency Contact
Please complete all required information. It is of the utmost importance that we have current phone contacts that connect to people who can care for your student in the event of an emergency. We have room for three contacts and are requiring two. If you have questions you can reach me at cmanthe@sjusd.org. You only need to do this once each school year but can enter it as often as you need when it changes.
Student Name *
Your answer
Current School
Please list medical conditions, life threatening allergies or medications taken.
Your answer
Primary Parent/Guardian Contact *
Your answer
Contact Phone *
Your answer
Email Address *
Your answer
Parent/Guardian 2 *
Your answer
Contact Phone 2 *
Your answer
Email Address 2 *
Your answer
Parent/Guardian 3
Optional but recommended.
Your answer
Contact Phone 3
Your answer
Email Address 3
Your answer
Medical Care Acknowledgement *
By entering my name below, I acknowledge that I am the parent or guardian of the student listed above and give permission for Charles Manthe, Anne-Marie Katemopoulos and Rebecca Bullard to make medical care decisions in the event that neither I nor any of my contacts can be reached. In serious emergencies, I agree that the aforementioned staff will call 911 if they believe it is necessary before calling a parent or contact and will not hold staff responsible for charges incurred by doing so.
Your answer
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