Minor Child Emergency Information and Parent Guardian 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name as the natural parent or legal guardian in the designated field.
3. Fill in your child's full name, including last and first names, along with their Social Security number and date of birth.
4. Provide your child's street address, city, and zip code accurately.
5. Enter your area code and home phone number, followed by a cell phone number if applicable.
6. Indicate whether your child may receive a pre-employment physical and emergency treatment by checking the appropriate boxes.
7. Complete the emergency contact section with the name, relationship, address, and phone numbers of the primary contact.
8. If necessary, fill out details for an alternate adult contact in case the primary cannot be reached.
9. Answer all health-related questions regarding allergies, medications, and any medical history that may affect treatment.
10. Finally, sign and date the form to authorize emergency medical treatment for your child.

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