Daycare emergency contact form with pick-up list
Parents, backup contacts, who can and cannot pick up, doctor and emergency medical permission, all on one form. Add your center details and download.
- Fill in your detailsYour center, room and dates.
- Make it yoursEdit, add or remove anything. Turn parts on or off.
- Check the previewIt updates as you type.
- Download PDFOr get a blank copy to fill in by hand.
Each section below shows what will print. Use the switch to keep or remove a section, edit the policy wording, and add your own questions at the bottom.
Your own questions
OptionalWhat to include on an emergency contact form
- Every parent or guardian with cell and work numbers
- At least two backup contacts who live or work nearby
- Adults allowed to pick up, and anyone who is not allowed
- Doctor, hospital and insurance
- Allergies and medical conditions
- Signed permission for emergency medical care
Keep it current
Phone numbers change. Ask families to check their emergency form every six months and keep a copy in your emergency backpack and travel kit. Use the pick-up authorization form for one-time pick-ups.
Also see the child care emergency form for medical consent and insurance, and the child emergency contact form with cut-out backpack cards.
More free help for your day
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Common questions
What is a childcare emergency contact form?
A form with the phone numbers of parents and backup contacts, the adults allowed to pick up, the child's doctor and medical needs, and permission for emergency care.
How many emergency contacts should a child have?
At least two besides the parents, ideally people who live or work close to the center.
Is this emergency contact form free?
Yes. Add your details and download a printable form at no cost.