Super Kids’ Place (Arnold)
Emergency Evacuation Form
Please sign & return this form
I understand that in case of an emergency evacuation during Super Kids’ Place time my
child/ren __________________________ will walk to Asbury, on Church Rd.
Parents will pick up their children as soon as possible after being notified of the situation.
Parent’s Signature _________________________________
Home Address ____________________________________
Home Phone ________________Cell Phone_______________
Work Phone _________________________
Another Emerg. Contact _____________________________________
Emergency Evacuation Form
Please sign & return this form
I understand that in case of an emergency evacuation during Super Kids’ Place time my
child/ren __________________________ will walk to Asbury, on Church Rd.
Parents will pick up their children as soon as possible after being notified of the situation.
Parent’s Signature _________________________________
Home Address ____________________________________
Home Phone ________________Cell Phone_______________
Work Phone _________________________
Another Emerg. Contact _____________________________________