St. Peter's School
3310 St. Peter's Drive
Waldorf, Maryland 20601

Please return this form immediately

Name: ___________________________________________________

Please Print

Child(ren)'s Name Grade/Teacher

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Bus # (if they ride a bus) _______________

Home Phone # Father ______________________ Mother ____________________

Work Phone# Father _____________________ Mother ______________________

Cell Phone # Father ______________________ Mother ______________________

Local Emergency Contact Person

Name: ____________________________________________

Phone: ____________________________________________

In Case of Emergency my child(ren) should: (Check One)

_______ Remain in School

_________ Go home on the bus if the buses are transporting

I understand that in case of a lock down situation my child(ren) must remain in school until the school receives information that the lock-down restriction is lifted. I understand that I should not call the school.

 

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Parent Signature