Emergency Card FINAL Form 10-09 doc Manuscript submitted to SIMAX - liberty k12 az 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the child's name at the top of the form, followed by the updated date and date enrolled.
3. Fill in the home address, including street, city, state, and zip code. Ensure accuracy for emergency contact purposes.
4. Provide the child's date of birth and home phone number. Select the child's sex by marking either 'male' or 'female'.
5. Enter the names and contact numbers of parents or guardians, ensuring to include both mother and father details.
6. List individuals authorized to collect your child in emergencies. At least two contacts are required.
7. Complete the medical care section with a healthcare provider's name and contact number.
8. Indicate any allergies or medical conditions that require special attention, providing detailed instructions if necessary.
9. Finally, review all information for accuracy before signing and dating the form at the bottom.

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