Contact 2 — Small Forest School

If your registration has been confirmed, please complete the following Emergency Contact Form.

Name of Child:

First Name

Last Name

Name of Child 2:

First Name

Last Name

Name of Child 3:

First Name

Last Name

Name of Parent/Guardian:

First Name

Last Name

Home Phone:

(###)

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Cell Phone:

(###)

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Work Phone:

(###)

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Physical Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Parent/Guardian:

First Name

Last Name

Home Phone:

(###)

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Cell Phone:

(###)

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Work Phone:

(###)

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Name of Emergency Contact 1:

Preferably someone local who also has permission to transport your child.

First Name

Last Name

Cell Phone:

(###)

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Work Phone:

(###)

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Relationship to Child:

Name of Emergency Contact 2:

First Name

Last Name

Cell Phone:

(###)

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Work Phone:

(###)

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Relationship to Child:

Please list any pertinent medical information such as dietary restrictions or allergies:

Name of Physician & Clinic:

Office Phone Number:

(###)

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Please share the names and ages of siblings and the types and names of pets; this just helps us understand more of their stories!

Photo Consent

Small Forest School may wish to take photographs or videos of the Student while participating in the outdoor program for the purposes of promoting the business of Small Forest School. Please indicate below as to whether you consent or do not consent to Small Forest School taking such photographs and/or videos of the Student and using the photographs and videos in its promotional materials and social media.

Yes, I consent to Small Forest School taking photographs and videos of the Student and using such photographs and videos in its promotional materials.

No, I do not consent to Small Forest School taking photographs and videos of the Student and using such photographs and videos in its promotional materials.