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Summer Emergency Contact Information

by dan — last modified Wednesday, January 20, 2010, 08:40 PM

IMPORTANT! Kansas City Amigos parents, please read this carefully. Please fill out the online form below to let us know exactly how the Kansas City Amigos chapter can reach you this summer in the event of an emergency.

Especially if parents are living separately, we need to know how to contact both parents. If you are planning to be out of town, let us know the dates and how to reach you then. Please be as clear and complete as you can about vacations. We will soon notify you as to how YOU can contact Amigos and your child, in the event of an emergency that you might have. Thanks!

(Be sure to scroll down, fill out all fields, and click submit when finished.)

Your E-Mail Address (Required)

Volunteer Info

Volunteer's Full Name (Required)

Volunteer's Email Address

Volunteer's Project

Mother's Info

Mother's Full Name (Required)

Mother's Email Address

Mother's Home Phone

Mother's Work Phone

Mother's Cell Phone

Father's Info

Father's Full Name (Required)

Father's Email Address

Father's Home Phone

Father's Work Phone

Father's Cell Phone

Emergency Contact Info

Emergency Contact Full Name (Required)

Emergency Contact Email Address

Emergency Contact Home Phone

Emergency Contact Work Phone

Emergency Contact Cell Phone

Vacations

Vacation Dates ("n/a" if not applicable) (Required)

How can we reach you on vacation?

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Summer Emergency Contact Information