Employee Emergency Information Please fill out this form so that we have all your information in case of an emergency. Name * First Name Last Name What would you like the children and other staff to call you? * Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Health insurance name and policy number (if applicable) Do you have any allergies or health conditions? Emergency contact #1 (name, phone, relationship) Emergency contact #2 (name, phone, relationship) Anything else we should know in the event of an emergency? Thank you!
