• Emergency Home Contact Instructions

    Dear Parents/Guardians:

    Your immediate attenttion to this letter is important for the safety and well-being of your child.

    Attached you will find a Home Contact Information form for the main office.  A copy will be given to the school nurse.  Both pages must be completed and signed by you.  It is important that you complete every section of the form.  The more information that you provide to us, the beter we can assist your child/ children in an emergency.  Please print all the required information as clearly as possible.

    If at any time there is a change to your documented information, you must notify the school either in person or in writing.  We cannot release your child to anyone who is not listed on the Emergency Contact Form.  You may list as many individuals as you deem necessary (i.e. grandparents, aunts/uncles, friends) who you would allow to pick up your child.  Please remember identification is necessary when signing a child out.

    Since we have no way of verifying the identity of a person calling the school, we will not honor telephone requests by you to release your child to a person not listed on the information form.  In the event of an emergency, we must have written permission signed by you, to release your child to someone other than those listed on the emergency Home Contact Information form.

    "May Not Have Access" : This section should be completed only if there is a person that your child cannot have contact with or be released to.  In this case, you must provide the school with Court Orders to keep on file.  The school maintains a confidential Custodial Rights file that we refer to when necessary.  A letter from you or your attorney denying access to a child is not considered a legal court document and we cannot comply with such requests.  Please submit appropriate documents to the school.

    List first &last names of all siblings and the school they attend.  Include children who do not attend P.S. 204.

    Signature of Parent/Guardian:  You must sign this form or it will be returned to you.

    Return the Emergency Contact form to your child's teacher as soon as possible.


    Thank you for your cooperation.

    Nancy Tomasuolo