• First Aid & Emergency Medical Consent

  • Parent Emergency Contact Information

    Please provide the best phone numbers to reach you in the event of an emergency during DSU program hours.
  • Emergency Contacts (in order to be contacted)

  • Physician Information

    Please provide the name, phone, and address of your child's pediatrician or family doctor.
  • Health Insurance

  • The name of the insurer.
  • Please provide your child's Health Insurance Policy Number
  • Consent