Primary Emergency Contact definition
Examples of Primary Emergency Contact in a sentence
Yes No If you answered yes or if any information has changed since last season, please complete the fields below: Address: City: Zip: Primary Contact Name/Phone: Email: Primary Emergency Contact Name/Phone: Participant’s School/Work: Teacher/Contact Name: School/Work Phone: Diagnosis: Yes, I would like to make a donation to NSSRA Foundation.
Yes ☐ No ☐ Moderate-intensity activities For example, bike riding, scootering or skateboarding Yes ☐ No ☐ Light activities For example, leisurely walking, playing handball or walking your dog Yes ☐ No ☐ Item 3: Primary Emergency Contact Name Relationship to Participant Mobile Alternate number Email Item 4: Alternate Emergency Contact Name Relationship to Participant Mobile Alternate number The information you are requested to give will be used to record medical, accident and other details.
Yes / No) Primary Emergency Contact: Relationship: Phone 1 & 2: / **Parent or Emergency contact must be available at one of these numbers during camp hours** Secondary Emergency Contact: Relationship: (Other than parent) Phone 1 & 2: / APPLICATION FORM I would like for my child, , to be considered for Camp Journey.
Yes / No) Primary Emergency Contact: Relationship: Phone 1 & 2: / (Other than parent) Phone 1 & 2: / APPLICATION FORM I would like for my child, , to be considered for Camp Journey.