BLUE CARD
Greetings Ryan Families,
Please fill out this digital Blue Card in its entirety. Please only complete this for each Ryan student in the household. This only has to be completed one time.

Blessings,
Mr.Nichols
PARENT EMAIL ADDRESS (PLEASE DOUBLE CHECK WHEN TYPING) *
Student Last Name *
Student First Name *
Student Middle Initial *
Student Date of Birth *
MM
/
DD
/
YYYY
Class (PLEASE CAPITALIZE THE LETTER ex. 6A5 not 6a5 ) *
Male or Female *
Student ID # *
Parent Guardian (Student resides with) *
Relationship *
Parent preferred Language of Communication *
Home Telephone *
Work Telephone *
Cell Phone # *
Address *
Other Parent/Guardian Name *
Relationship *
Other Parent/Guardian Name Preferred Language *
Other Parent/Guardian Name Home Phone # *
Other Parent/Guardian Name Work Telephone # *
Other Parent/Guardian Name Cell Phone # *
Other Parent Guardian Email *
Other Parent Guardian Mailing Address (ONLY IF DIFFERENT) *
LIST below names of three (1 person of 3) persons who may be called in case of emergency or if child is sick in school. (NAME,TELEPHONE NUMBER,RELATIONSHIP)
LIST below names of three (2 person of 3) persons who may be called in case of emergency or if child is sick in school. (NAME,TELEPHONE NUMBER,RELATIONSHIP)
LIST below names of three (3 person of 3) persons who may be called in case of emergency or if child is sick in school. (NAME,TELEPHONE NUMBER,RELATIONSHIP)
Is there is a person who may NOT HAVE ACCESS to child, please indicate: *
Order of Protection Exist? *
Name of Physician/Clinic *
Physician Telephone #
Does child have any health condition that may affect participation in physical activities? *
Limitations (If none place N/A) *
Allergies (If none place N/A) *
504 services for the current year? *
Did you receive 504 services last year? *
My child has *
If none of the named contacts can be reached, what do you wish the school to do if your child is sick or injured? (It is understood that in the final disposition of an emergency case,the judgement of the school authorities will prevail. The recommendation of the parent as indicated below will be respected as far as possible. *
Siblings? *
Sibling Last Name *
Sibling First Name *
School of Attendance *
Another Sibling
Clear selection
Sibling Last Name *
Sibling First Name *
Sibling School of Attendance *
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