Student Emergency Contact Form
Hello Girard Families,
Please use this form to update your child's emergency contact information. It is very important that we are able to reach you if there is an emergency. You may use this one form for all students in your household.

Please submit any legal custody paperwork to the main office of the school.




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Stephen Girard Elementary
Student(s) Full First and Last Name(s) *
Room number(s) for your child(ren).  Check all that apply.
Does your family need support with getting internet access? *
Parent/Guardian 1 First and Last Name *
Parent/Guardian 1 Email *
Parent/Guardian 1 Phone Number *
Parent/Guardian 1 Street Address *
Parent/Guardian 2 First and Last Name
Parent/Guardian 2 Email address
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Street Address
Full Name of Emergency Contact 1 *
What is the relationship of Emergency Contact 1 to your child? *
Phone Number for Emergency Contact 1 *
Full Name of Emergency Contact 2 *
What is the relationship of Emergency Contact 2 to your child?
Clear selection
Phone Number for Emergency Contact 2 *
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