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Back to School Forms (Emergency Contact and Permission to Pick Up)

Please complete the form below. All fields are required. Forms must be complete prior to the start of the academic school year along with copies of immunization records.

Family Emergency Contact Information (please list all children in household who attend RGS)

Child One Name *

Answer Required

Child One grade (beginning in fall of 2020)

Answer Required

Child Two Name

Answer Required

Child Two Grade (beginning in fall of 2020)

Answer Required

Child Three Name

Answer Required

Child Three Grade (beginning in fall of 2020)

Answer Required

Pequenos

Grandes

Kindergarten

1st

2nd

3rd

4th

5th

6th

Name and relationship of any person(s) UNAUTHORIZED to see or pick up these students

Answer Required

Names and relationships of people AUTHORIZED to pick up students

Answer Required

Emergency Contacts (person must be able to pick up child(ren) if we are unable to reach you. Please list at LEAST TWO contacts.

Name of Emergency contact, One

Answer Required

Phone of Emergency Contact, One (best number to reach contact)

Number Required

Name of Emergency Contact, Two

Answer Required

Phone of Emergency Contact, two (best number to reach contact)

Number Required

Name of Emergency Contact, three

Answer Required

Phone of Emergency Contact, three (best number to reach contact)

Number Required

Confirmation Email

Confirmation Email *

Email Required