I understand in case of an emergency, that Verlyn Music may call 911.
Doctor contact number
Please list any medical and/or physical ailment your child has that we should know about.
If your child has any allergies, please list them:
Any child with food allergies must bring their own lunch and snacks daily.
In case of emergency please call:
Name direct contact #
Name direct contact #
Name direct contact #
Sign:
Date:
