Emergency Contact Form

Looking for an Emergency Contact Form template for your school? Use this free template from FutureFund. Instantly integrates into your free FutureFund account.

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Emergency Contact Form

Please fill out student information below.

Student First Name: *

Student Last Name: *

Grade:

Student Home Address: *

Please fill out parent or guardian information below.

Parent/Guardian Full Name: *

Parent/Guardian Phone Number: *

Parent/Guardian Email: *

Relationship to Student: *

Please fill out emergency contact information below. If there is more than one, please add in the additional person(s) information:

Emergency Contact Full Name #1: *

Emergency Contact Phone Number #1: *

Emergency Contact Email #1: *

Emergency Contact Full Name #2:

Emergency Contact Phone Number #2:

Emergency Contact Email #2:

By signing this agreement, I acknowledge that I am the parent or legal guardian of the student and confirm that the emergency contact information provided is accurate and up to date. I understand that in the event of an emergency, the school will use this information to contact me or the designated emergency contact.

Use the space above to sign your name